Healthcare Provider Details

I. General information

NPI: 1437295383
Provider Name (Legal Business Name): LESLIE ANN RODNAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 14TH ST NW WHITMAN-WALKER CLINIC
WASHINGTON DC
20009
US

IV. Provider business mailing address

1701 14TH STREET NW WHITMAN-WALKER CLINIC
WASHINGTON DC
20009
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-6159
  • Fax: 202-745-0238
Mailing address:
  • Phone: 202-745-6159
  • Fax: 202-745-0238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD14565
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: