Provider Demographics
NPI:1497847347
Name:LEHR, SHANNON CATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:CATHERINE
Last Name:LEHR
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:PO BOX 17334
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1334
Mailing Address - Country:US
Mailing Address - Phone:703-443-6717
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:44055 RIVERSIDE PKWY
Practice Address - Street 2:SUITE 246
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5179
Practice Address - Country:US
Practice Address - Phone:703-858-3200
Practice Address - Fax:703-858-3203
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242164208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1497847347Medicaid
VA020568L19Medicare PIN