MEDICARE: DR. LEONARD L D'ADDESI 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	207X00000X	Orthopaedic Surgery Physician	MD425209	PA
2	207X00000X	Orthopaedic Surgery Physician	94330	GA
3	207XS0106X	Orthopaedic Hand Surgery Physician	MD425209	PA
4	207XS0106X	Orthopaedic Hand Surgery Physician	94330	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50079399	OTHER	PA	CAPITAL BLUE CROSS
2	D2055757	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1548462179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD L D'ADDESI MD

Provider Business Mailing Address
First Line	:	15 MEDICAL DR NE STE 101
Second Line	:
City	:	CARTERSVILLE
State	:	GA
Zip	:	30121-8005
Country	:	US
Telephone Number	:	770-386-5221
Fax Number	:	770-386-1128

Provider Business Practice Location Address
First Line	:	15 MEDICAL DR NE STE 101
Second Line	:
City	:	CARTERSVILLE
State	:	GA
Zip	:	30121-8005
Country	:	US
Telephone Number	:	770-386-5221
Fax Number	:	770-386-1128

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

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	12/09/2024

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Directions to “ DR. LEONARD L D'ADDESI MD” Practice Location

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