Provider Demographics
NPI:1548215353
Name:MALIVER, LEONARD ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ERIC
Last Name:MALIVER
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 1:841 HOSPITAL RD
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3620
Mailing Address - Country:US
Mailing Address - Phone:724-349-7820
Mailing Address - Fax:724-349-8816
Practice Address - Street 1:841 HOSPITAL RD
Practice Address - Street 2:SUITE 2400
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3620
Practice Address - Country:US
Practice Address - Phone:724-349-7820
Practice Address - Fax:724-349-8816
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032966E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010158120004Medicaid
PAE38674Medicare UPIN
PA0027803Medicare ID - Type Unspecified