Provider Demographics
NPI:1588693436
Name:LEKAWA, THADDEUS (MD)
Entity type:Individual
Prefix:DR
First Name:THADDEUS
Middle Name:
Last Name:LEKAWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1800
Mailing Address - Fax:717-851-1810
Practice Address - Street 1:1010 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3864
Practice Address - Country:US
Practice Address - Phone:717-851-1800
Practice Address - Fax:717-851-1810
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028203L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA015052OtherHIGHMARK BLUE SHIELD
PA1567479OtherGATEWAY-WMG WRC
PA250357OtherMAMSI-WMG JFM
PA01070902OtherCAPITAL BC-WMG JFM
PA50062677OtherCAPITAL BLUE CROSS-WMG RC
PAP002810OtherGATEWAY-WMG
PA032646OtherJOHNS HOPKINS
MD546800OtherCAREFIRST MD BCBS
PA186094OtherUNISON-WMG RC
PA80926OtherUNISON-WMG JFM
PA001656273Medicaid
PA1142398OtherAH MERCY-WMG JFM
PA20054650OtherAH MERCY-WMG RC
PA2161250OtherMAMSI-WMG RC
PA40366OtherGEISINGER
PA4584202OtherAETNA
PAB32404Medicare UPIN
PAP002810OtherGATEWAY-WMG
PA4584202OtherAETNA