Provider Demographics
NPI:1962409854
Name:LEINEWEBER, FELICIA SWILLING (PA-C)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:SWILLING
Last Name:LEINEWEBER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:5601 LOCH RAVEN BLVD
Mailing Address - Street 2:STE 3
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2905
Mailing Address - Country:US
Mailing Address - Phone:443-444-3775
Mailing Address - Fax:443-444-4678
Practice Address - Street 1:5205 CHAIRMANS CT STE 100
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-2916
Practice Address - Country:US
Practice Address - Phone:301-696-0012
Practice Address - Fax:301-696-0016
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC0002308363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P65007Medicare UPIN