Michael A Leatherwood, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0021031 Issued in MD

Practice address

12070 Old Line Ctr
Suite 302
Waldorf, MD 20602-2513

Phone

(301) 645-6667

Fax

(301) 870-9722

NPI assigned

Aug 17, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Privia Care Center LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1164874426

  MD

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC, MD

  Medicare reassignment NPD
• Menocal Medical Services PA

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1083795918
  NPD
• Privia Care Center LLC

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1730664012
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1497747349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206040249",
            "telephone_number": "301-645-6667",
            "fax_number": "301-870-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "SUITE 302",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513",
            "telephone_number": "301-645-6667",
            "fax_number": "301-870-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERWOOD",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0021031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olujare-Abiola Lawal
• Nicole Lawrence, LICSW
• Dominique Darnise Lawson, PSYD
• Lca Psychological Associates, LLC
• Natasha Leake, LMSW
• Amanda Lee
• Axel Lee
• Leteace Lee, IBCLC, RN
• Nicole Janee' Lee, M.D.
• Youjin Lee, PT

• Internal Medicine Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.