Healthcare Provider Details

I. General information

NPI: 1417613431
Provider Name (Legal Business Name): LEON ALLEN DRUMM CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2021
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14090 HG TRUEMAN RD SUITE 2500
SOLOMONS MD
20688-3151
US

IV. Provider business mailing address

985 PRINCE FREDERICK BLVD SUITE 201
PRINCE FREDERICK MD
20678-3492
US

V. Phone/Fax

Practice location:
  • Phone: 410-535-2005
  • Fax: 410-535-4850
Mailing address:
  • Phone: 410-535-2005
  • Fax: 410-535-4850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024183077
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR192039
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: