Provider Demographics
NPI:1427040070
Name:LEHIGH, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:LEHIGH
Suffix:
Gender:M
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:PO BOX 37086
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3086
Mailing Address - Country:US
Mailing Address - Phone:410-775-2622
Mailing Address - Fax:410-775-2050
Practice Address - Street 1:104 N MAIN ST
Practice Address - Street 2:
Practice Address - City:UNION BRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21791-9102
Practice Address - Country:US
Practice Address - Phone:410-775-2622
Practice Address - Fax:410-775-2050
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
969180OtherUNITED
W590-0002OtherCAREFIRST BCBS GHMSI
416791-01OtherCAREFIRST BCBS MARYLAND
780199OtherAETNA PVN
MD955BMedicare PIN
780199OtherAETNA PVN