Provider Demographics
NPI:1164429429
Name:LESCHEK, RICHARD T (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:LESCHEK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 THOMAS JOHNSON DR
Mailing Address - Street 2:202
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4402
Mailing Address - Country:US
Mailing Address - Phone:301-698-8300
Mailing Address - Fax:301-698-8389
Practice Address - Street 1:172 THOMAS JOHNSON DR
Practice Address - Street 2:202
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4402
Practice Address - Country:US
Practice Address - Phone:301-698-8300
Practice Address - Fax:301-698-8389
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH453062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD53050409OtherBCBS LOCAL
MD613557OtherMDIPA
MD2120058OtherMAMSI
MD0002OtherBCBS
MD2120058OtherMAMSI