Provider Demographics
NPI:1962513754
Name:LEAFBLAD, DANIEL P (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:LEAFBLAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3366 OAKDALE AVE N
Mailing Address - Street 2:#450
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422
Mailing Address - Country:US
Mailing Address - Phone:763-257-4400
Mailing Address - Fax:763-520-1791
Practice Address - Street 1:3366 OAKDALE AVE N
Practice Address - Street 2:#450
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:763-257-4400
Practice Address - Fax:763-520-1791
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN24886207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D81702Medicare UPIN