Provider Demographics
NPI:1477544344
Name:SHUE, LEO L (MD)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:L
Last Name:SHUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4720 HORNBEAM DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1419
Mailing Address - Country:US
Mailing Address - Phone:301-570-9700
Mailing Address - Fax:301-260-2838
Practice Address - Street 1:2401 RESEARCH BLVD 350
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6211
Practice Address - Country:US
Practice Address - Phone:301-330-6983
Practice Address - Fax:301-330-6984
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0060557207R00000X
MDD60557207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
012921I06Medicare ID - Type Unspecified
H98737Medicare UPIN
MD003027A51Medicare PIN