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Individual

MS. AMBER LYNNE LEASE-GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1223E NATIONAL HWY, LAVALE, MD 21502-7602
(240) 807-8340
Mailing address
1223E NATIONAL HWY, LAVALE, MD 21502-7602
(240) 807-8340

Taxonomy

Speciality
Code
Description
License number
State
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
1528701406
MD
246RP1900X
Phlebotomy Technician
Primary

Other

Enumeration date
04/18/2022
Last updated
05/11/2022
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