MEDICARE: LETHA MARY HEALEY MD

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	207R00000X	Internal Medicine Physician	D0062456	MD
2	207RI0200X	Infectious Disease Physician	MD33271	DC
3	207RI0200X	Infectious Disease Physician	D0062456	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972733590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LETHA MARY HEALEY MD

Provider Business Mailing Address
First Line	:	10206 GREENFIELD ST
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-4128
Country	:	US
Telephone Number	:	240-743-4125
Fax Number	:

Provider Business Practice Location Address
First Line	:	1458 ADDISON RD S
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-4413
Country	:	US
Telephone Number	:	301-324-1500
Fax Number	:	301-324-6405

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

Provider Enumeration Date	:	07/16/2009
Last Update Date	:	02/16/2023

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Directions to “ LETHA MARY HEALEY MD” Practice Location

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