Provider Demographics
NPI:1801849575
Name:ROBINSON, LESLIE B (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:B
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:BERKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10010 FALLS OF NEUSE RD
Mailing Address - Street 2:STE 103
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8494
Mailing Address - Country:US
Mailing Address - Phone:919-848-9451
Mailing Address - Fax:919-848-9758
Practice Address - Street 1:10010 FALLS OF NEUSE RD
Practice Address - Street 2:STE 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8494
Practice Address - Country:US
Practice Address - Phone:919-848-9451
Practice Address - Fax:919-848-9758
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9601458OtherNC MEDICAL BOARD
BR5318008OtherDEA
NC9601458OtherNC MEDICAL BOARD
NC2245375DMedicare PIN
G74174Medicare UPIN