Organization Active NPI

Lance G. Leithauser, M D P a

  • Plastic Surgery Physician
  • Rockville, MD
National Provider Identifier
1073811857
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
D0021581 Issued in MD
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

Updated by the provider on Mar 4, 2011

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)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
189061100MedicaidMD

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.