MEDICARE: MRS. SHEILA LESSMAN PHYSICIANS ASSISTANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	C000079	MD

General Provider Information

NPI Number	:	1255498085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEILA LESSMAN PHYSICIANS ASSISTANT

Provider Business Mailing Address
First Line	:	7 AUTUMN WINDS CT
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-5601
Country	:	US
Telephone Number	:	410-308-2765
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 AUTUMN WIND COURT
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-1234
Country	:	US
Telephone Number	:	410-308-2765
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2007

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