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NPI Code Detail

MEDICARE: MICHAEL J. LEIDING MD

MEDICARE: MICHAEL J. LEIDING MD
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician036109751IL
2207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianDR.0057326CO
3207RG0300XGeriatric Medicine (Internal Medicine) PhysicianDR.0057326CO

General Provider Information

NPI Number : 1063447795
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J. LEIDING MD
Provider Business Mailing Address
First Line : 5730 EXECUTIVE DR STE 230
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1762
Country : US
Telephone Number : 303-876-8320
Fax Number : 888-701-4175
Provider Business Practice Location Address
First Line : 3235 MILL VISTA RD
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80129-2440
Country : US
Telephone Number : 303-876-8320
Fax Number : 888-701-4175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 03/21/2023

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