MEDICARE: DR. CRAIG L LEONARDI 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	207N00000X	Dermatology Physician	100484	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	03-01945	OTHER	UNITED HEALTHCARE
2	119184	OTHER	ANTHEM BCBS
3	359544	OTHER	PHCS
4	5592178	OTHER	AETNA
5	300574	OTHER	HEALTH PARTNERS

General Provider Information

NPI Number	:	1477626869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG L LEONARDI M.D.

Provider Business Mailing Address
First Line	:	1034 S BRENTWOOD BLVD
Second Line	:	SUITE 600
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-1206
Country	:	US
Telephone Number	:	314-721-5565
Fax Number	:	314-721-6122

Provider Business Practice Location Address
First Line	:	1034 S BRENTWOOD BLVD
Second Line	:	SUITE 600
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-1206
Country	:	US
Telephone Number	:	314-721-5565
Fax Number	:	314-721-6122

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. CRAIG L LEONARDI M.D.” Practice Location

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