Organization
CRUZ-LEE-LLACER & ASSOCIATES P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATESA SHANMUGAM (TREASURER)
(301) 868-7780
Entity
Organization
Contact information
Practice address
8909 OLD BRANCH AVE, CLINTON, MD 20735-2528
(301) 868-7780
(202) 403-0508
Mailing address
8909 OLD BRANCH AVE, CLINTON, MD 20735-2528
(301) 868-7780
(202) 403-0508
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D0050412
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
289091700
—
MD
01
—
6875
CAREFIRST BLUE CROSS
DC
01
—
C10291
UNITEDHEALTHCARERAILROAD
MD
Enumeration date
03/01/2007
Last updated
09/09/2014
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