Provider Demographics
NPI:1023116514
Name:NAPOLITANO, LEAH (MD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:NAPOLITANO
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 1:707 CEDAR ST STE 405
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-2059
Mailing Address - Country:US
Mailing Address - Phone:574-335-8707
Mailing Address - Fax:574-335-0741
Practice Address - Street 1:12563 STATE RD 23
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-9226
Practice Address - Country:US
Practice Address - Phone:574-335-8300
Practice Address - Fax:574-335-0775
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070462A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1102217877OtherANTHEM
IN201053110Medicaid
IN000000756951OtherBC/BS INDIANA
IN187720092OtherMEDICARE
IN201053110AMedicaid
IN000001222143OtherANTHEM
IN000001399348OtherANTHEM
ININ1933089OtherMEDICARE
INP01091386OtherMEDICARE RR
IN000001394730OtherANTHEM