MEDICARE: STEVEN TODD LEDER 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
1	207L00000X	Anesthesiology Physician	MD 23707	SC
2	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	MD23707	SC
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	MD 23707	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225018971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN TODD LEDER MD

Provider Business Mailing Address
First Line	:	2317 DUNCAN ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-3137
Country	:	US
Telephone Number	:	864-884-1143
Fax Number	:	803-647-5726

Provider Business Practice Location Address
First Line	:	6539 GARNERS FERRY ROAD
Second Line	:	WJB DORN VAMC -DEPARTMENT OF ANESTHESIOLOGY
City	:	COLUMBIA
State	:	SC
Zip	:	29209
Country	:	US
Telephone Number	:	803-776-4000
Fax Number	:	803-647-5726

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	01/08/2009

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