Provider Demographics
NPI:1184794638
Name:LESLIE, CHASHERYL L (MD)
Entity type:Individual
Prefix:MS
First Name:CHASHERYL
Middle Name:L
Last Name:LESLIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2000 MEDICAL PKWY STE 409
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3746
Mailing Address - Country:US
Mailing Address - Phone:667-204-7212
Mailing Address - Fax:443-481-4151
Practice Address - Street 1:4175 N HANSON CT STE 209
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3184
Practice Address - Country:US
Practice Address - Phone:301-352-4007
Practice Address - Fax:301-352-3316
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0057324207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD013557OtherJHHC
MD01462059OtherAMERIGROUP
MD5329598OtherCIGNA
MD7525268OtherAETNA
MD022888501Medicaid
MD1184794638OtherTRICARE
MDY8880001OtherCAREFIRST
MD013557OtherJHHC
MD022888501Medicaid