Provider Demographics
NPI:1104895366
Name:LEONARD, RONALD A (MD PHD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:A
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4273
Mailing Address - Country:US
Mailing Address - Phone:610-630-6888
Mailing Address - Fax:610-630-6940
Practice Address - Street 1:700 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4273
Practice Address - Country:US
Practice Address - Phone:610-630-6888
Practice Address - Fax:610-630-6940
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038191E174400000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1087339Medicaid
PA1087339Medicaid
PA177389GGEMedicare ID - Type Unspecified