MEDICARE: ALEXANDRIA MARIE LEDUC MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0101X	MOHS-Micrographic Surgery Physician	A194957	CA
2	207N00000X	Dermatology Physician	A194957	CA

General Provider Information

NPI Number	:	1477180982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA MARIE LEDUC MD

Provider Business Mailing Address
First Line	:	3105 CEDAR RAVINE RD
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-6561
Country	:	US
Telephone Number	:	925-786-0738
Fax Number	:

Provider Business Practice Location Address
First Line	:	3105 CEDAR RAVINE RD
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-6561
Country	:	US
Telephone Number	:	925-786-0738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	01/20/2026

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