Basic Information
| Provider Information | |||||||||
| NPI: | 1245252667 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEUNG | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 ARCH ST. | ||||||||
| Address2: | STE. 506 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303753894 | ||||||||
| FaxNumber: | 3303756680 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 ARCH ST. | ||||||||
| Address2: | STE. 506 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303753894 | ||||||||
| FaxNumber: | 3303756680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 10/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 34.008662 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 4188461 | 01 | OH | MEDICARE ID | OTHER | 2664200 | 05 | OH | MEDICAID |