| David D. Leonard, M.d. Pc | |
|
3911 Blenheim Blvd Ste 41c Fairfax VA 22030-2434 | |
| (703) 352-7100 | |
| (703) 539-8579 |
| Full Name | David D. Leonard, M.d. Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3911 Blenheim Blvd Ste 41c, Fairfax, Virginia |
| Authorized Official Name and Position | David Drake Leonard (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7033527100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David D. Leonard, M.d. Pc 3911 Blenheim Blvd Ste 41c Fairfax VA 22030-2434 Ph: (703) 352-7100 | David D. Leonard, M.d. Pc 3911 Blenheim Blvd Ste 41c Fairfax VA 22030-2434 Ph: (703) 352-7100 |
| NPI Number | 1366570400 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 03/08/2023 |
| Medicare PECOS PAC ID | 5698863678 |
|---|---|
| Medicare Enrollment ID | O20071109000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366570400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101043356 (Virginia) | Primary |
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| Provider Name | Kathleen T Crane Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194885277 PECOS PAC ID: 0840388823 Enrollment ID: I20071109000186 |
| Provider Name | David D Leonard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013077148 PECOS PAC ID: 1850489832 Enrollment ID: I20071109000201 |
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