Individual
DR. MICHAEL C LEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 SAN PEDRO DR SE, NMVAHCS (501/110), ALBUQUERQUE, NM 87108-5153
(505) 265-1711
(505) 256-5466
Mailing address
1501 SAN PEDRO DR SE, NMVAHCS (501/110), ALBUQUERQUE, NM 87108-5153
(505) 265-1711
(505) 256-5466
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
93-94
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M14656
PRE-11/92 PROVIDER NUMBER
MA
Enumeration date
07/17/2006
Last updated
07/08/2007
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