Basic Information
| Provider Information | |||||||||
| NPI: | 1659553626 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEST | ||||||||
| FirstName: | LEE-ANNE | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24419 MILLSTREAM DR | ||||||||
| Address2: | |||||||||
| City: | ALDIE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201055837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035382043 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3001 S HANOVER ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103503565 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2007 | ||||||||
| LastUpdateDate: | 07/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080H0002X | 0101264991 | VA | N | Allopathic & Osteopathic Physicians | Pediatrics | Hospice and Palliative Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RH0002X | 0101264991 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
No ID Information.