Provider Demographics
NPI:1184812018
Name:LEARY, DAVID B (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:LEARY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:DEPARTMENT OF THE AIR FORCE
Mailing Address - Street 2:18 OMRS/CC, UNIT 5268, BLDG 626, KADENA AB, JAPAN
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96368-5268
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18 MEDICAL GROUP, UNIT 5268
Practice Address - Street 2:BLDG 626, KADENA AIR BASE
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5268
Practice Address - Country:US
Practice Address - Phone:315-630-4283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2025-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY253314207Q00000X, 2083A0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program