Active NPI
Lance G. Leithauser, M D P a
- Plastic Surgery Physician
- Rockville, MD
National Provider Identifier
1073811857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- D0021581
- Legal business name
- LANCE G. LEITHAUSER, M D P A
- Practice address
- 9715 Medical Center Dr
Suite 535
Rockville, MD 20850-3320 - Phone
- (301) 294-9400
- Fax
- (301) 294-0149
- NPI assigned
- Mar 3, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lance G. Leithauser, M.D.
- Title
- M.D.
- Phone
- (301) 294-9400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | D0021581 | MD | Primary |
Addresses
Primary practice location
9715 Medical Center Dr
Suite 535
Rockville, MD 20850-3320
Mailing address
9715 Medical Center Dr
Suite 535
Rockville, MD 20850-3320
Phone (301) 294-9400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 189061100 | Medicaid | MD |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299110400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1299196800000",
"number": "1073811857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9715 MEDICAL CENTER DR",
"address_2": "SUITE 535",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503320",
"telephone_number": "301-294-9400",
"fax_number": "301-294-0149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9715 MEDICAL CENTER DR",
"address_2": "SUITE 535",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503320",
"telephone_number": "301-294-9400",
"fax_number": "301-294-0149"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LANCE G. LEITHAUSER, M D P A",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-03",
"last_updated": "2011-03-04",
"status": "A",
"authorized_official_last_name": "LEITHAUSER",
"authorized_official_first_name": "LANCE",
"authorized_official_middle_name": "G.",
"authorized_official_title_or_position": "M.D.",
"authorized_official_telephone_number": "301-294-9400",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": "MD",
"license": "D0021581",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "189061100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.