Provider Demographics
NPI:1952491672
Name:KADIE LEACH MD PA
Entity Type:Organization
Organization Name:KADIE LEACH MD PA
Other - Org Name:KADIE E LEACH MD
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR PRIMARY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KADIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-577-5818
Mailing Address - Street 1:9500 ANNAPOLIS RD
Mailing Address - Street 2:SUITE A1
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:301-577-5818
Mailing Address - Fax:301-577-4120
Practice Address - Street 1:9500 ANNAPOLIS RD
Practice Address - Street 2:SUITE A1
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-577-5818
Practice Address - Fax:301-577-4120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty