Provider Demographics
NPI:1548259997
Name:PENNINGTON, LEE R (MD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:R
Last Name:PENNINGTON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:19735 GERMANTOWN ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874
Mailing Address - Country:US
Mailing Address - Phone:301-917-6513
Mailing Address - Fax:301-917-6506
Practice Address - Street 1:10215 FERNWOOD RD
Practice Address - Street 2:STE 100
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817
Practice Address - Country:US
Practice Address - Phone:301-493-4440
Practice Address - Fax:301-493-9778
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2010-07-27
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Provider Licenses
StateLicense IDTaxonomies
MDD0021115207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B99051Medicare UPIN