Individual
REYNALDO LABITAG LEE-LLACER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8600 SNOWDEN RIVER PKWY STE 307, COLUMBIA, MD 21045-1986
(410) 290-0012
(410) 290-0015
Mailing address
8600 SNOWDEN RIVER PKWY, SUITE 307, COLUMBIA, MD 21045-1982
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0061829
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0041
CAREFIRST
—
01
—
122122
JHHC
—
01
—
1503644
AETNA HMO
—
01
—
270887.
AMERIGROUP
—
05
—
406470400
—
MD
01
—
64241604
CAREFIRST
—
01
—
7832636
AETNA PPO
—
Enumeration date
08/15/2006
Last updated
08/07/2024
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