1841456043 NPI number — KARENGA R. LEMMONS, MD, LLC

Table of content: (NPI 1841456043)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841456043 NPI number — KARENGA R. LEMMONS, MD, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KARENGA R. LEMMONS, MD, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841456043
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9811 MALLARD DR
Provider Second Line Business Mailing Address:
SUITE 118/119/120
Provider Business Mailing Address City Name:
LAUREL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20708-3143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-559-2515
Provider Business Mailing Address Fax Number:
301-559-2517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3311 TOLEDO TER
Provider Second Line Business Practice Location Address:
STE C105
Provider Business Practice Location Address City Name:
HYATTSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20782-4135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-559-2515
Provider Business Practice Location Address Fax Number:
301-559-2517
Provider Enumeration Date:
08/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SIBERT
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PRACTICE MANAGEMENT CONSULTANT
Authorized Official Telephone Number:
301-938-8605

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D0031711 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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