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General NPI Number Information
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NPI Number | 1073811857
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Entity Type | Organization
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Legal Business Name | LANCE G. LEITHAUSER, M D P A
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 9715 MEDICAL CENTER DR SUITE 535
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City | ROCKVILLE
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State | MD
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Zip | 20850-3320
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Country | US
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Telephone | 301-294-9400
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Fax | 301-294-0149
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Provider Business Mailing Address
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Address Line | 9715 MEDICAL CENTER DR SUITE 535
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City | ROCKVILLE
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State | MD
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Zip | 20850-3320
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Country | US
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Telephone | 301-294-9400
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Fax | 301-294-0149
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Authorized Official
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Title or Position | M.D.
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Name | LANCE G. LEITHAUSER
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Credential | M.D.
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Telephone | 301-294-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | D0021581
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License Number State | MD
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