Provider Demographics
NPI:1326155615
Name:LENARD, PETER D (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:D
Last Name:LENARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1485 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4501
Mailing Address - Country:US
Mailing Address - Phone:703-734-2890
Mailing Address - Fax:703-734-0305
Practice Address - Street 1:1485 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4501
Practice Address - Country:US
Practice Address - Phone:703-734-2890
Practice Address - Fax:703-734-0305
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101025268208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA73-5105-4Medicaid
VA73-5105-4Medicaid
B93946Medicare UPIN