Organization
MID-ATLANTIC ENT, LLC
Active
Other names
Anne Arundel ENT & Facial Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE ALLAN KLEIMAN MD (MEDICAL DIRECTOR)
(410) 573-9191
Entity
Organization
Contact information
Practice address
600 RIDGELY AVE STE 110, ANNAPOLIS, MD 21401-1082
(410) 573-9191
(410) 573-5910
Mailing address
600 RIDGELY AVE STE 110, ANNAPOLIS, MD 21401-1082
(410) 573-9191
(410) 573-5910
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502528100
—
MD
01
—
9001272
AETNA
MD
01
—
FN66-0000
CAREFIRST BCBS
—
Enumeration date
02/09/2021
Last updated
10/10/2022
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