Provider Demographics
NPI:1407869936
Name:CAUDLE, LESTER CLEGG III (MD, MTM & H)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:CLEGG
Last Name:CAUDLE
Suffix:III
Gender:M
Credentials:MD, MTM & H
Other - Prefix:
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Mailing Address - Street 1:1 COBLENTZ CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-7857
Mailing Address - Country:US
Mailing Address - Phone:301-371-5157
Mailing Address - Fax:
Practice Address - Street 1:6900 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0003
Practice Address - Country:US
Practice Address - Phone:703-681-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064145174400000X
NC31716174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist