Individual
DR. LANCE G LEITHAUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9715 MEDICAL CENTER DR, 535, ROCKVILLE, MD 20850-3320
(301) 294-9400
(301) 294-0149
Mailing address
9715 MEDICAL CENTER DR, 535, ROCKVILLE, MD 20850-3320
(301) 294-9400
(301) 294-0149
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
D0021581
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05008
AMERIGROUP
MD
01
—
0819656
AETNA
MD
05
—
189061100
—
MD
01
—
20071
MAMSI
MD
01
—
41680702
CF BC/BS MD
MD
01
—
9440-0001
CF BC/BS NCA
MD
Enumeration date
08/10/2005
Last updated
03/03/2011
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