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General NPI Number Information
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NPI Number | 1003006412
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Entity Type | Organization
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Legal Business Name | LESLIE H FENTON MD
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 6614 MELODY LANE
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City | BETHESDA
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State | MD
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Zip | 20817
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Country | US
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Telephone | 301-365-0266
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Fax | 301-365-3253
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Provider Business Mailing Address
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Address Line | 6614 MELODY LANE
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City | BETHESDA
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State | MD
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Zip | 20817
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Country | US
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Telephone | 301-365-0266
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Fax | 301-365-3253
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. LESLIE HOWARD FENTON
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Credential | MD
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Telephone | 301-365-0266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D01254
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101016877
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2853
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License Number State | DC
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