Provider Demographics
NPI:1447330170
Name:GIRMSCHEID, LESLIE A (MD, NCTMB)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
Last Name:GIRMSCHEID
Suffix:
Gender:F
Credentials:MD, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 APPLE TREE LN
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-5100
Mailing Address - Country:US
Mailing Address - Phone:207-272-6027
Mailing Address - Fax:
Practice Address - Street 1:3 APPLE TREE LN
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-5100
Practice Address - Country:US
Practice Address - Phone:207-272-6027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT3957225700000X
MA54028207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine