Provider Demographics
NPI:1851576748
Name:LEMAS, MARIO VICTOR (PHD)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:VICTOR
Last Name:LEMAS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 ORLEANS ST
Mailing Address - Street 2:CRB1-387
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0013
Mailing Address - Country:US
Mailing Address - Phone:410-614-5411
Mailing Address - Fax:410-955-0960
Practice Address - Street 1:1650 ORLEANS ST
Practice Address - Street 2:CRB1-387
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0013
Practice Address - Country:US
Practice Address - Phone:410-614-5411
Practice Address - Fax:410-955-0960
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician