Provider Demographics
NPI:1386632461
Name:LEOPOLD, LANCE (MD)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:LEOPOLD
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 1:1441 CATLIN WAY
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1035
Mailing Address - Country:US
Mailing Address - Phone:610-203-9328
Mailing Address - Fax:866-305-6063
Practice Address - Street 1:1441 CATLIN WAY
Practice Address - Street 2:
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025-1035
Practice Address - Country:US
Practice Address - Phone:610-203-9328
Practice Address - Fax:866-305-6063
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044489E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014168200001Medicaid
E52929Medicare UPIN
574802KUSMedicare ID - Type Unspecified