Provider Demographics
NPI:1780664060
Name:LELAND, WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:LELAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MOYE BLVD. VMC- MA ROOM 350
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-1935
Mailing Address - Country:US
Mailing Address - Phone:252-744-4964
Mailing Address - Fax:
Practice Address - Street 1:600 MOYE BLVD # MA350
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-847-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501313207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC110114730OtherRAILROAD MEDICARE
NC51662OtherBCBS
NC60911OtherMEDCOST
NC2952265OtherUNITED HEALTHCARE
NC8951662Medicaid
NC2219323Medicare ID - Type Unspecified
NC8951662Medicaid
NCF43201Medicare UPIN