Madsen, Leesa M
Madsen, Leesa M is an individual health care provider with primary practice located at 2722 Merrilee Dr Suite 230, Fairfax VA 22031-4400. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Madsen, Leesa M can be contacted via phone (703) 698-4483.Contact Information
Primary practice address
2722 Merrilee Dr Suite 230
Fairfax VA 22031-4400
Phone: (703) 698-4483
Fax: (703) 573-0880
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 0110840790 | Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 0110840790 | Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | 0110840790 | Virginia |
Profile Details
| NPI number | 1386669307 |
|---|---|
| LBN Legal business name | Madsen, Leesa M |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Apr 30th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386669307 | NPPES |
| Virginia | MEDICAID | 0101317452 | |
| Virginia | Other | 259998 | |
| Virginia | MEDICAID | 010317274 | |
| Virginia | MEDICAID | 0101305055 | |
| Virginia | MEDICAID | 0101310791 | |
| Virginia | MEDICAID | 0101316774 | |
| Virginia | MEDICAID | 0101317347 | |
| Virginia | MEDICAID | 010316855 | |
| Virginia | MEDICAID | 010317452 | |
| Virginia | MEDICAID | 010304989 | |
| Virginia | MEDICAID | 010316910 | |
| Virginia | MEDICAID | 010317401 | |
| Virginia | MEDICAID | 010316847 | |
| Virginia | MEDICAID | 010316936 | |
| Virginia | MEDICAID | 010317240 | |
| Virginia | MEDICAID | 010317312 | |
| Virginia | MEDICAID | 010317428 | |
| Virginia | MEDICAID | 0101317371 | |
| Virginia | MEDICAID | 010316839 | |
| Virginia | MEDICAID | 010316804 |
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