Provider Demographics
NPI:1205823234
Name:LEONARD, MARIA IRMA SANTOS (MD)
Entity Type:Individual
Prefix:
First Name:MARIA IRMA
Middle Name:SANTOS
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3205 N ACADEMY BLVD
Mailing Address - Street 2:STE 130
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5152
Mailing Address - Country:US
Mailing Address - Phone:719-632-5700
Mailing Address - Fax:719-344-7865
Practice Address - Street 1:4022 ZUCK RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4592
Practice Address - Country:US
Practice Address - Phone:814-877-5424
Practice Address - Fax:814-877-5423
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2018-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD427597208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H45517Medicare UPIN