Healthcare Provider Details

I. General information

NPI: 1346360237
Provider Name (Legal Business Name): CECELIA TERREATHEA LESTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 FLOWER AVE
TAKOMA PARK MD
20912
US

IV. Provider business mailing address

7401 FLOWER AVE
TAKOMA PARK MD
20912
US

V. Phone/Fax

Practice location:
  • Phone: 301-891-3030
  • Fax: 301-891-2859
Mailing address:
  • Phone: 301-891-3030
  • Fax: 301-891-2859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number029666
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1200378
Identifier TypeOTHER
Identifier State
Identifier IssuerUHC
# 2
IdentifierP2781
Identifier TypeOTHER
Identifier State
Identifier IssuerADVENTIST HEALTH CARE
# 3
Identifier0533451
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA
# 4
Identifier52361
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerAMERIGROUP
# 5
Identifier52361
Identifier TypeOTHER
Identifier State
Identifier IssuerAMERIGROUP
# 6
Identifier031652
Identifier TypeOTHER
Identifier State
Identifier IssuerPRIORITY PARTNERS
# 7
Identifier000717160003
Identifier TypeOTHER
Identifier State
Identifier IssuerUHC CHOICE PLUS POINT OF
# 8
Identifier64100001
Identifier TypeOTHER
Identifier State
Identifier IssuerBCBS
# 9
Identifier8
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerMDIPAOC
# 10
Identifier86714
Identifier TypeOTHER
Identifier State
Identifier IssuerMDIPA
# 11
Identifier3746641100
Identifier TypeOTHER
Identifier State
Identifier IssuerMEDICARD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: