Healthcare Provider Details

I. General information

NPI: 1710046230
Provider Name (Legal Business Name): JEFFREY THOMAS LENERT M.D., M.B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NATIONAL NAVAL MEDICAL CTR 8901 WISCONSIN AVE.
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

7986 FOXMOOR DR
DUNN LORING VA
22027-1146
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4440
  • Fax: 301-295-9059
Mailing address:
  • Phone: 703-573-4520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number01010456713
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: