Provider Demographics
NPI:1669056743
Name:LESTERSMITH, DREW STEVEN
Entity type:Individual
Prefix:MR
First Name:DREW
Middle Name:STEVEN
Last Name:LESTERSMITH
Suffix:
Gender:
Credentials:
Other - Prefix:MR
Other - First Name:STEVEN
Other - Middle Name:DREW
Other - Last Name:LESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-614-3234
Mailing Address - Fax:410-550-1345
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-614-3234
Practice Address - Fax:410-550-1345
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program