Provider Demographics
NPI:1114217411
Name:LEONG, NATALIE L (MD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:L
Last Name:LEONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64134
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4134
Mailing Address - Country:US
Mailing Address - Phone:667-214-2714
Mailing Address - Fax:410-448-6926
Practice Address - Street 1:351 W CAMDEN ST STE 501
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2493
Practice Address - Country:US
Practice Address - Phone:410-448-6400
Practice Address - Fax:410-244-0635
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036142609207XX0005X
MDPENDING207XX0005X, 207X00000X
CAA124051207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery