Healthcare Provider Details

I. General information

NPI: 1659553626
Provider Name (Legal Business Name): LEE-ANNE S WEST MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S HANOVER ST
BALTIMORE MD
21225
US

IV. Provider business mailing address

22805 CREIGHTON FARMS DR
LEESBURG VA
20175-6009
US

V. Phone/Fax

Practice location:
  • Phone: 410-350-3565
  • Fax:
Mailing address:
  • Phone: 443-956-1045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number0101264991
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number0101264991
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberD0069338
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: