Provider Demographics
NPI:1922003060
Name:DE LEON, FERNANDO C (MD)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:C
Last Name:DE LEON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:920 ELKRIDGE LANDING RD
Mailing Address - Street 2:STE 310
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2917
Mailing Address - Country:US
Mailing Address - Phone:443-462-5010
Mailing Address - Fax:410-684-2031
Practice Address - Street 1:10710 CHARTER DRIVE
Practice Address - Street 2:STE 310
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3260
Practice Address - Country:US
Practice Address - Phone:410-997-5944
Practice Address - Fax:410-997-1720
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2016-10-18
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Provider Licenses
StateLicense IDTaxonomies
MDD0046120207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF87519Medicare UPIN