MEDICARE: DR. DAVID LEONARD HAROLD 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	174400000X	Specialist	DHO32177	MI
2	208800000X	Urology Physician	4301032177	MH

General Provider Information

NPI Number	:	1659393833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID LEONARD HAROLD M.D.

Provider Business Mailing Address
First Line	:	20952 E 12 MILE RD
Second Line	:	SUITE 200
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48081-3200
Country	:	US
Telephone Number	:	586-771-4820
Fax Number	:	586-771-6620

Provider Business Practice Location Address
First Line	:	2346 WALNUT LAKE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-3740
Country	:	US
Telephone Number	:	248-408-0599
Fax Number	:	248-322-6108

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	01/14/2021

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