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Individual

DR. DAVID M LEDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2000 S THOMPSON ST, FLAGSTAFF, AZ 86001-8759
(928) 226-6400
(928) 226-6410
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036-127978
IL
207RC0000X
Cardiovascular Disease Physician
Primary
54873
AZ
207RI0011X
Interventional Cardiology Physician
036-127978
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1912218850
NPI GROUP PRACTICE
IL
05
320529
AZ
01
54873
STATE OF ARIZONA
AZ
01
IL4174015
MEDICARE-LOCALITY 16
IL
01
IL4177015
MEDICARE-LOCALITY 15
IL
Enumeration date
11/16/2006
Last updated
01/14/2021
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