Provider Demographics
NPI:1477660926
Name:LEONARD, SHARLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARLEEN
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-5954
Mailing Address - Country:US
Mailing Address - Phone:414-573-3267
Mailing Address - Fax:
Practice Address - Street 1:10340 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:STURTEVANT
Practice Address - State:WI
Practice Address - Zip Code:53177-1607
Practice Address - Country:US
Practice Address - Phone:262-687-7500
Practice Address - Fax:262-687-7501
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30314300Medicaid
AL8251857OtherDEA NUMBER
AL8251857OtherDEA NUMBER
B54538Medicare UPIN