Healthcare Provider Details

I. General information

NPI: 1164008769
Provider Name (Legal Business Name): LEAH DANIEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7927 RITCHIE HWY
GLEN BURNIE MD
21061-4345
US

IV. Provider business mailing address

12936 BEETHOVEN BLVD
SILVER SPRING MD
20904-6871
US

V. Phone/Fax

Practice location:
  • Phone: 410-761-2273
  • Fax:
Mailing address:
  • Phone: 240-899-7423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0102852
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0102852
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: