Provider Demographics
NPI:1790773182
Name:LEICH, JULIUS K (MD)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:K
Last Name:LEICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:J
Other - Middle Name:K
Other - Last Name:LEICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3100 SPRING FOREST ROAD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-882-0705
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:5801 BREMO ROAD
Practice Address - Street 2:AMERICAN ANESTHESIOLOGY OF VIRGINIA, PC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1907
Practice Address - Country:US
Practice Address - Phone:973-660-9334
Practice Address - Fax:804-282-9921
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039874207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5721024Medicaid
VA000462490Medicare ID - Type Unspecified
VAD99877Medicare UPIN