Provider Demographics
NPI:1336151711
Name:MARION, LESTER I (MD)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:I
Last Name:MARION
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:PO BOX 71094
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20813-1094
Mailing Address - Country:US
Mailing Address - Phone:202-870-0237
Mailing Address - Fax:301-986-8037
Practice Address - Street 1:5550 FRIENDSHIP BLVD
Practice Address - Street 2:STE T-90
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7256
Practice Address - Country:US
Practice Address - Phone:301-656-3555
Practice Address - Fax:301-986-8037
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD9970207RG0100X
MDD0020447207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC021401100Medicaid
DC100005116OtherMEDICARE RAILROAD
D17991Medicare UPIN
DC021401100Medicaid