Provider Demographics
NPI:1801020771
Name:HERSHMAN, LEAH BAIR (DO)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:BAIR
Last Name:HERSHMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 REGIONAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9868
Mailing Address - Country:US
Mailing Address - Phone:910-338-3381
Mailing Address - Fax:910-226-0197
Practice Address - Street 1:6 REGIONAL DR STE C
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9868
Practice Address - Country:US
Practice Address - Phone:910-338-3381
Practice Address - Fax:910-226-0197
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-016632086S0129X, 208600000X
MI5101017969208600000X
AZ006438208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCZ168026OtherMEDICARE PTAN