DR. LESLIE STANISLAUS ANEWENAH (NPI# 1508110198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508110198 |
| Entity Type | Individual |
| Full Name | DR. LESLIE STANISLAUS ANEWENAH |
| Credential | MD |
| Practice Address |
1770 E Lake Shore Dr Decatur IL 62521-3832 |
| Mailing Address |
84-2 Ferne Blvd Drexel Hill PA 19026-5510 |
| Practice Telephone | 2173291000 |
| Mailing Telephone | 3029835330 |
| Enumeration Date | 2012-11-04 |
| Last Update Date | 2019-05-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 036149330 | IL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 79450 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1770 E LAKE SHORE DR |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-3832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292412 | David Anthony Jones | Family Medicine | 1770 E Lake Shore Dr, Suite 305, Decatur, IL 62521-3832 | 2005-08-19 |
| 1306314778 | Kristy Dawn Shafer | Nurse Practitioner | 1770 E Lake Shore Dr, Decatur, IL 62521-3832 | 2018-11-05 |
| 1902340730 | Annie Michele Smith | Social Worker | 1770 E Lake Shore Dr, #209, Decatur, IL 62521-3832 | 2016-12-13 |
| 1013319623 | Nicole Marie Lord | Nurse Practitioner | 1770 E Lake Shore Dr, #309, Decatur, IL 62521-3832 | 2014-09-25 |
| 1063797108 | Laurel A Walton Do Sc | Obstetrics & Gynecology | 1770 E Lake Shore Dr, Ste 309, Decatur, IL 62521-3832 | 2011-10-20 |
| 1447532924 | Ahmad H Ahmad Md Sc | Internal Medicine | 1770 E Lake Shore Dr, Ste 201, Decatur, IL 62521-3832 | 2011-09-12 |
| 1912233602 | Linda Wilson Klemm | Nurse Practitioner | 1770 E Lake Shore Dr, Suite 105, Decatur, IL 62521-3832 | 2009-10-30 |
| 1265675490 | Jennifer Ross-barnett | Nurse Practitioner | 1770 E Lake Shore Dr, Suite 207, Decatur, IL 62521-3831 | 2009-04-17 |
| 1447403936 | Choudary V. Kavuri Md, Sc | Psychiatry & Neurology | 1770 E Lake Shore Dr, Suite 208, Decatur, IL 62521-3832 | 2008-10-28 |
| 1205098738 | Danxuan Long | Internal Medicine | 1770 E Lake Shore Dr, Decatur, IL 62521-3832 | 2008-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083087340 | Alabama Bariatrics and Minimally Invasive Surgery, PC | Surgery | 705 Bank St Ne, Decatur, AL 35601-1609 | 2015-11-09 |
| 1639515778 | Sean P Mcgrath | Surgery | 2675 N Decatur Rd Ste 609, Decatur, GA 30033-6137 | 2013-05-16 |
| 1558505511 | Heath Colin Smith | Surgery | 2014 Ben Merritt Dr Ste A, Decatur, TX 76234-3851 | 2009-04-21 |
| 1235323551 | William R Hardcastle Md PC | Surgery | 487 Winn Way Ste 103, Decatur, GA 30030-1700 | 2007-08-29 |
| 1699834184 | Hugh Comer Nabers Jr. | Surgery | 1215 7th St Se Ste 190, Decatur, AL 35601-3393 | 2006-12-08 |
| 1396772851 | Alexandra Lara Barr Webb | Surgery | Va Medical Center Atlanta, 1670 Clairemont Road (112), Decatur, GA 30033 | 2006-06-28 |
| 1851342638 | Mark G Goss | Surgery | 2301 S Fm 51, Suite 500, Decatur, TX 76234-3865 | 2006-05-15 |
| 1073562583 | Daniel K Morris | Surgery | 2250 S Fm 51, Suite #900, Decatur, TX 76234-3766 | 2006-05-10 |
| 1225087562 | William E Wallace | Surgery | 2000 Ben Merritt Dr, Suite B, Decatur, TX 76234-3848 | 2006-05-06 |
| 1457318016 | Robert Charles Walker | Surgery | 1405 7th St Se, Decatur, AL 35601 | 2006-04-27 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.