Basic Information
| Provider Information | |||||||||
| NPI: | 1275689945 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LESTER | ||||||||
| FirstName: | NORMAN | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10403 HOSPITAL DR | ||||||||
| Address2: | SUITE G-4 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207353134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018563019 | ||||||||
| FaxNumber: | 3018569370 | ||||||||
| Practice Location | |||||||||
| Address1: | 10401 HOSPITAL DR | ||||||||
| Address2: | SUITE G-4 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207353110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018770891 | ||||||||
| FaxNumber: | 3018560536 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 10/15/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | D0045647 | MD | Y | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | MD21781 | DC | N | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 0W54TP | 01 | BLUE CROSS | OTHER | 624316 | 01 | DC | MEDICARE GROUP NUMBER FOR CLINTON ENT | OTHER | B776 | 01 | DC | BCBS GROUP NUMBER FOR CLINTON ENT | OTHER |