Physician Compare National (NPI:1861547283)

HEALTHCARE PROVIDER: MICHAEL HENRI LEONIDOV M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1861547283
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648451500
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110224000787
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEONIDOV
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6206 OLD FRANCONIA RD
	Group Practice or individual's line 1 address
City	ALEXANDRIA
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	223102529
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7039224601
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490040
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	INOVA ALEXANDRIA HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y