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General NPI Number Information
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NPI Number | 1013280916
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Entity Type | Individual
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Provider Name | MONICA RENEE LEID PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 3261 OLD WASHINGTON RD STE 3010
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City | WALDORF
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State | MD
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Zip | 20602-3229
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Country | US
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Telephone | 855-527-7246
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Fax | 866-229-5063
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Provider Business Mailing Address
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Address Line | 201 DEFENSE HWY STE 205
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7096
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Country | US
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Telephone | 855-527-7246
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Fax | 866-229-5063
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0004455
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License Number State | MD
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