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Organization
SIRJ, LLC
Active
Organization
SIRJ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON M LEE-LLACER M.D. (SOLE OWNER)
(443) 977-8406
Entity
Organization
Contact information
Practice address
8118 GOOD LUCK RD, LANHAM, MD 20706-3574
(443) 977-8406
Mailing address
12 E LAFAYETTE AVE, BALTIMORE, MD 21202-2847
(443) 977-8406
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
NULL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
09/15/2010
Last updated
09/15/2010
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