MEDICARE: DR. DAVID C. LEOPOLD M.D.

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	202D00000X	Integrative Medicine Physician	25MA10062000	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00143343	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00A798470	OTHER	BLUE SHIELD OF CA
4	B008	OTHER	CHAMPUS

General Provider Information

NPI Number	:	1023082518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID C. LEOPOLD M.D.

Provider Business Mailing Address
First Line	:	331 NEWMAN SPRINGS RD
Second Line	:	BLDG 2, STE 220
City	:	RED BANK
State	:	NJ
Zip	:	07701-5688
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 DAVIS AVE
Second Line	:	FL 1
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-4488
Country	:	US
Telephone Number	:	732-263-7999
Fax Number	:

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	07/08/2025

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