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Individual

DR. JOSHUA D LEIDERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1235 8TH ST, LAS VEGAS, NM 87701-4219
(505) 425-6788
(505) 425-5408
Mailing address
PO BOX 158, ESPANOLA, NM 87532-0158
(505) 753-7218
(505) 753-5815

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A93209
CA
207Q00000X
Family Medicine Physician
Primary
MD2010-0809
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A932090
CA
Enumeration date
05/28/2006
Last updated
06/25/2015
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