Provider Demographics
NPI:1174622906
Name:LEONARD, MICHAEL SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:STRONG MEMORIAL HOSPITAL
Mailing Address - Street 2:601 ELMWOOD AVE, BOX 667
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-276-4113
Mailing Address - Fax:585-275-0707
Practice Address - Street 1:STRONG MEMORIAL HOSPITAL
Practice Address - Street 2:601 ELMWOOD AVE, BOX 667
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-276-4113
Practice Address - Fax:585-275-0707
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213130208M00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01925171Medicaid
G05637Medicare UPIN
BB9272Medicare ID - Type Unspecified