Provider Demographics
NPI:1801267042
Name:LEDNUM HEARING CENTERS, LLC
Entity type:Organization
Organization Name:LEDNUM HEARING CENTERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:STAFF AUDIOLOGIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:NOBLE
Authorized Official - Last Name:LEDNUM
Authorized Official - Suffix:III
Authorized Official - Credentials:MA
Authorized Official - Phone:443-521-0576
Mailing Address - Street 1:400 MARYLAND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-1928
Mailing Address - Country:US
Mailing Address - Phone:410-228-1676
Mailing Address - Fax:410-228-7464
Practice Address - Street 1:400 MARYLAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1928
Practice Address - Country:US
Practice Address - Phone:410-228-1676
Practice Address - Fax:410-228-7464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDL204OtherCAREFIRST BC BS
MD226020OtherMAMSI/UNITED HEALTHCARE