Provider Demographics
NPI:1346360237
Name:LESTER, CECELIA TERREATHEA (MD)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:TERREATHEA
Last Name:LESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 FLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912
Mailing Address - Country:US
Mailing Address - Phone:301-891-3030
Mailing Address - Fax:301-891-2859
Practice Address - Street 1:7401 FLOWER AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912
Practice Address - Country:US
Practice Address - Phone:301-891-3030
Practice Address - Fax:301-891-2859
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD029666208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1200378OtherUHC
P2781OtherADVENTIST HEALTH CARE
0533451OtherAETNA
MD52361OtherAMERIGROUP
52361OtherAMERIGROUP
031652OtherPRIORITY PARTNERS
000717160003OtherUHC CHOICE PLUS POINT OF
64100001OtherBCBS
MD8OtherMDIPAOC
86714OtherMDIPA
3746641100OtherMEDICARD