Organization
MARIAN A. LLENADO-LEE, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAN A LLENADO-LEE MD (PRESIDENT)
(937) 395-9542
Entity
Organization
Contact information
Practice address
3533 SOUTHERN BLVD # 3750, KETTERING, OH 45429
(937) 395-9542
Mailing address
3533 SOUTHERN BLVD # 3750, KETTERING, OH 45429
(937) 395-9542
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000038658
ANTHEM BLUE CROSS AND BLU
OH
01
—
000000333555
ANTHEM BLUE CROSS
OH
05
—
0598607
—
OH
01
—
MA9346561
MEDICARE GROUP NO.
OH
Enumeration date
05/03/2007
Last updated
10/19/2007
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