Provider Demographics
NPI:1073563078
Name:LEINBERRY, CHARLES F (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:LEINBERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST
Mailing Address - Street 2:SUITE 1402
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:800-321-9999
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:925 CHESTNUT ST FL 5
Practice Address - Street 2:ROTHMAN INSTITUTE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4206
Practice Address - Country:US
Practice Address - Phone:267-339-6500
Practice Address - Fax:215-503-0580
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034449E207XS0106X
NJ25MA08608100207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4263975OtherAETNA IND PROVIDER #
PA0429822000OtherIBC IND PROVIDER #
PAP00075615OtherRR MEDICARE IND PROV #
PAP737755OtherOXFORD IND PROVIDER #
PA607173OtherBS IND PROVIDER #
PAP00187573Medicare PIN
PAP00075615OtherRR MEDICARE IND PROV #
PA0473490001Medicare PIN
PA607173JJWMedicare ID - Type UnspecifiedMEDICARE IND PROVIDER #