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NPI Code Detail

MEDICARE: CARL LEDERMAN M.D.

MEDICARE: CARL LEDERMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianMD9179DC
22085R0202XDiagnostic Radiology PhysicianD0021603MD
32085R0202XDiagnostic Radiology Physician0101028941VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043219660
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARL LEDERMAN M.D.
Provider Business Mailing Address
First Line : 4700 BERWYN HOUSE RD
Second Line : SUITE 208
City : COLLEGE PARK
State : MD
Zip : 20740-2474
Country : US
Telephone Number : 301-220-0150
Fax Number : 301-220-1032
Provider Business Practice Location Address
First Line : 1150 VARNUM ST NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20017-2180
Country : US
Telephone Number : 202-269-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 11/01/2007

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