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
Fax: (703) 573-0880
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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