Provider Demographics
NPI:1891303038
Name:LEGGIO, LORENZO (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LORENZO
Middle Name:
Last Name:LEGGIO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 CRYSTAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7919
Mailing Address - Country:US
Mailing Address - Phone:202-826-8834
Mailing Address - Fax:
Practice Address - Street 1:NIH/NIDA, BAYVIEW CAMPUS
Practice Address - Street 2:BRC, 251 BAYVIEW BOULEVARD, ROOM 01A844
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:443-740-2801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD48413208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice