Healthcare Provider Details

I. General information

NPI: 1235831900
Provider Name (Legal Business Name): MICHAEL PATRICK LEAMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W AGENCY RD
WEST BURLINGTON IA
52655-1659
US

IV. Provider business mailing address

1401 W AGENCY RD
WEST BURLINGTON IA
52655-1659
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-4970
  • Fax:
Mailing address:
  • Phone: 319-768-4970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number137520
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number137520
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: