Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 036109751 | IL |
Y | 207RG0300X | Geriatric Medicine | DR.0057326 | CO |
N | 207RH0002X | Hospice and Palliative Medicine | DR.0057326 | CO |
NPI | 1063447795 |
---|---|
Provider Name | Michael J. Leiding |
First Address | Denver, CO 80230-7030 |
Second Address | Lakewood, CO 80226-2908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I16499 | (02) |