Provider Demographics
NPI:1588653786
Name:KANE, LEONARD E (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:E
Last Name:KANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:85 THOMAS JOHNSON CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4331
Mailing Address - Country:US
Mailing Address - Phone:301-663-9440
Mailing Address - Fax:301-663-4602
Practice Address - Street 1:85 THOMAS JOHNSON CT
Practice Address - Street 2:SUITE B
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4331
Practice Address - Country:US
Practice Address - Phone:301-663-9440
Practice Address - Fax:301-663-4602
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2015-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0061884207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDJ931-0002OtherBCBS OF D.C.
MD2125821OtherMAMSI
MD642183-01OtherCAREFIRST BLUE CROSS
MD52-2111986OtherUNITED HEALTHCARE
MD52-2111986OtherCIGNA
MD408259100Medicaid
MD641LJ276Medicare PIN
MD52-2111986OtherCIGNA