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General NPI Number Information
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NPI Number | 1659547818
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Entity Type | Individual
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Provider Name | LEONARD KHALIL KASSIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 350 SUITE D FORTUNE TERR
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City | ROCKVILLE
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State | MD
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Zip | 20854-2972
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Country | US
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Telephone | 301-309-0016
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Fax | 301-309-0174
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Provider Business Mailing Address
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Address Line | 350 SUITE D FORTUNE TERRACE
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City | ROCKVILLE
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State | MD
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Zip | 20854-2972
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Country | US
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Telephone | 301-309-0016
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Fax | 301-309-0174
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0054434
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License Number State | MD
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