# BALTIMORE-WASHINGTON FACIAL PLASTIC SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366759938
- **Authorized official:** DR. THOMAS T. LE M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (877) 917-3223

## Contact information

- **Practice address:** 4785 DORSEY HALL DR, SUITE 111, ELLICOTT CITY, MD 21042-7728
- **Practice address phone:** (877) 917-3223
- **Practice address fax:** (443) 219-0758
- **Mailing address:** 4785 DORSEY HALL DR, SUITE 111, ELLICOTT CITY, MD 21042-7728
- **Mailing address phone:** (877) 917-3223
- **Mailing address fax:** (443) 219-0758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | D0061873 | MD | Yes |

## Other

- **Enumeration date:** 09/02/2010
- **Last updated:** 01/29/2012