DEMETRE LEDLUM (NPI# 1730644295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730644295 |
| Entity Type | Individual |
| Full Name | DEMETRE LEDLUM |
| Practice Address |
2660 Deer Isle Cv Lawrenceville GA 30044-5263 |
| Practice Telephone | 4049560878 |
| Mailing Telephone | 4049560878 |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2660 DEER ISLE CV |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30044-5263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740811892 | Berry and Mitchell Hands of Caring | Nurse's Aide | 1180 Market Square Lane, Lawrenceville, GA 30044 | 2020-01-28 |
| 1457995045 | Reagan Urgent Care | Clinic/Center | 2878 Five Forks Trickum Rd Ste 2a, Lawrenceville, GA 30044 | 2019-11-06 |
| 1194373621 | Kaseem Beck | Dentist | Gwinnett Family Dental Care, 3455 Lawrenceville Hwy, Lawrenceville, GA 30044 | 2019-08-28 |
| 1053965525 | Imani Anderson | Speech-Language Pathologist | 2775 Cruse Rd Suite 2002, Lawrenceville, GA 30044 | 2019-08-01 |
| 1598329625 | Zam Zam Family Clinic LLC | Clinic/Center | 965 Oakland Road, Bldg 3 Ste D & E, Lawrenceville, GA 30044 | 2019-04-24 |
| 1659858991 | Apex Eyecare | Optometrist | 3694 Club Drive Unit 101, Lawrenceville, GA 30044 | 2018-07-19 |
| 1538657549 | Georgia Comprehensive Family Clinic & Natural Health | Naturopath | 1065 Pleasant Hill Rd, Lawrenceville, GA 30044 | 2018-04-25 |
| 1316434095 | Children's Dentistry of Lithonia, LLC | Dentist | 4850 Sugarloaf Parkway, Ste 611, Lawrenceville, GA 30044 | 2018-04-18 |
| 1831619337 | Legacy Healthcare Services, Inc. | Occupational Therapist | 2899 Five Forks Trickum Rd Apt 204, Lawrenceville, GA 30044 | 2017-06-26 |
| 1326582859 | Ana Coronado | Social Worker | 965 Oakland Road Nw, Suite 3b, Lawrenceville, GA 30044 | 2016-12-19 |
| Find all providers in zip 30044 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790395796 | Stanley Nwachukwu | Student in an Organized Health Care Education/Training Program | 260 Sarah Ln, Lawrenceville, GA 30046-7455 | 2020-08-04 |
| 1417575796 | John Robert Thomas | Student in an Organized Health Care Education/Training Program | 2476 Planters Rd, Lawrenceville, VA 23868-3229 | 2020-07-13 |
| 1750904462 | Heather Ann Holmes | Student in an Organized Health Care Education/Training Program | 1901 Lexington Ave, Lawrenceville, IL 62439-2062 | 2020-05-28 |
| 1417578485 | Antjuan Hampton | Student in an Organized Health Care Education/Training Program | 1014 Natural Brook Trl, Lawrenceville, GA 30045-2615 | 2020-05-01 |
| 1821626409 | Prarthi Patel | Student in an Organized Health Care Education/Training Program | 1745 Lawrenceville Rd, Lawrenceville, NJ 08648-2948 | 2020-03-30 |
| 1467089219 | Mariam Baig | Student in an Organized Health Care Education/Training Program | 655 Duluth Hwy Ste 401, Lawrenceville, GA 30046-7672 | 2020-03-23 |
| 1760047138 | Yasmine Alkhalid | Student in an Organized Health Care Education/Training Program | 1220 Chadwick Point Dr, Lawrenceville, GA 30043-6289 | 2019-05-01 |
| 1750945069 | Stephanie Yui Duff | Student in an Organized Health Care Education/Training Program | 386 Gail Pond Dr, Lawrenceville, GA 30045-8715 | 2019-04-23 |
| 1588124523 | Umair Syed | Student in an Organized Health Care Education/Training Program | 665 Duluth Highway Suite 401, Lawrenceville, GA 30046-2017 | 2019-03-25 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30044 |
Please comment or provide details below to improve the information on DEMETRE LEDLUM.
| 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.