Provider Demographics
NPI:1215912332
Name:LEONARDI, CHERYL D (MD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:D
Last Name:LEONARDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:D
Other - Last Name:BURK-LEONARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4801 DORSEY HALL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7766
Mailing Address - Country:US
Mailing Address - Phone:410-997-4780
Mailing Address - Fax:410-997-3196
Practice Address - Street 1:4801 DORSEY HALL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7766
Practice Address - Country:US
Practice Address - Phone:410-997-4780
Practice Address - Fax:410-997-3196
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0042998207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD392216ZJKVMedicare PIN