Provider Demographics
NPI:1659370641
Name:FIRESTONE, LEE EDWARD (DPM)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:EDWARD
Last Name:FIRESTONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 825159
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-5159
Mailing Address - Country:US
Mailing Address - Phone:202-331-9727
Mailing Address - Fax:202-887-0741
Practice Address - Street 1:1775 K ST NW STE 580
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1529
Practice Address - Country:US
Practice Address - Phone:202-223-4616
Practice Address - Fax:202-223-0740
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1204213E00000X
DCP0546213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD079736701Medicaid
MD0797367 00Medicaid
DC027420300Medicaid
MD0797367 00Medicaid