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NPI Code Detail

MEDICARE: DR. JOSHUA D LEIDERMAN M.D.

MEDICARE: DR. JOSHUA D LEIDERMAN 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
1207Q00000XFamily Medicine PhysicianA93209CA
2207Q00000XFamily Medicine PhysicianMD2010-0809NM

Other Identifiers

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

General Provider Information

NPI Number : 1841247327
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA D LEIDERMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 158
Second Line :
City : ESPANOLA
State : NM
Zip : 87532-0158
Country : US
Telephone Number : 505-753-7218
Fax Number : 505-753-5815
Provider Business Practice Location Address
First Line : 1235 8TH ST
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4219
Country : US
Telephone Number : 505-425-6788
Fax Number : 505-425-5408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 06/25/2015

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