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Individual

DR. JASON M LEE-LLACER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2001 MEDICAL PKWY, ACUTE CARE PAVILION, ANNAPOLIS, MD 21401-3280
(443) 481-1000
Mailing address
PO BOX 64916, BALTIMORE, MD 21264-4916
(443) 481-6467
(443) 481-6515

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0064818
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0042
CAREFIRST
01
145724700
DEPT. OF LABOR
01
1503640
AETNA HMO
01
206362
JHHC
01
263508
KAISER
01
318699
AMERIGROUP
05
412132500
MD
01
7132906
AETNA PPO
01
89550101
CAREFIRST
Enumeration date
12/22/2006
Last updated
06/09/2008
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