Provider Demographics
NPI:1700820313
Name:SCHWAB, LEE EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:EDWARD
Last Name:SCHWAB
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 1:9357 COPENHAVER DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3023
Mailing Address - Country:US
Mailing Address - Phone:301-762-1115
Mailing Address - Fax:301-762-1115
Practice Address - Street 1:HOLY CROSS HOSPITAL
Practice Address - Street 2:1500 FOREST GLEN RD
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1484
Practice Address - Country:US
Practice Address - Phone:301-754-7061
Practice Address - Fax:301-754-7154
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022990207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D66453Medicare UPIN
MDG02080P01Medicare ID - Type Unspecified