MEDICARE: LORI R ANDREW M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101038093	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184626343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI R ANDREW M.D.

Provider Business Mailing Address
First Line	:	PO BOX 17334
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21297-1334
Country	:	US
Telephone Number	:	703-443-6717
Fax Number	:	703-443-8643

Provider Business Practice Location Address
First Line	:	46440 BENEDICT DR
Second Line	:	STE 207
City	:	STERLING
State	:	VA
Zip	:	20164-6602
Country	:	US
Telephone Number	:	703-444-2100
Fax Number	:	703-444-0386

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	01/09/2010

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