Provider Demographics
NPI:1245940881
Name:LEON, RAUL (MD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:LEON
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 1:50 UNION ST.
Mailing Address - Street 2:CNRHC PATHOLOGY DEPARTMENT
Mailing Address - City:GRAND FALLS-WINDSOR
Mailing Address - State:NL
Mailing Address - Zip Code:A2A 2Y7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 UNION ST.
Practice Address - Street 2:CNRHC PATHOLOGY DEPARTMENT
Practice Address - City:GRAND FALLS-WINDSOR
Practice Address - State:NL
Practice Address - Zip Code:A2A 2Y7
Practice Address - Country:CA
Practice Address - Phone:709-486-0026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427735207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology