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General NPI Number Information
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NPI Number | 1366537102
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Entity Type | Individual
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Provider Name | JOHN G. DELEONIBUS D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 2086 GENERALS HWY SUITE 101
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City | ANNAPOLIS
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State | MD
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Zip | 21401-6700
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Country | US
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Telephone | 410-266-7666
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Fax | 410-266-7703
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Provider Business Mailing Address
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Address Line | 2086 GENERALS HWY SUITE 101
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City | ANNAPOLIS
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State | MD
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Zip | 21401-6700
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Country | US
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Telephone | 410-266-7666
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Fax | 410-266-7703
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00899
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License Number State | MD
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