Organization
SIRJ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON LEE-LLACER M.D. (OWNER)
(443) 977-8406
Entity
Organization
Contact information
Practice address
7300 VAN DUSEN RD, LAUREL, MD 20707-9463
(301) 725-4300
Mailing address
PO BOX 2032, BALTIMORE, MD 21203-2032
(301) 498-2922
(301) 498-3074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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