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NPI Code Detail

MEDICARE: DR. LIMA LORREN REDHEAD MD

MEDICARE: DR. LIMA LORREN REDHEAD MD
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
1207V00000XObstetrics & Gynecology Physician036110499IL
2207V00000XObstetrics & Gynecology PhysicianD76568MD

Other Identifiers

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

General Provider Information

NPI Number : 1447283445
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LIMA LORREN REDHEAD MD
Provider Business Mailing Address
First Line : 26005 RIDGE RD STE 200
Second Line :
City : DAMASCUS
State : MD
Zip : 20872-1899
Country : US
Telephone Number : 301-414-2305
Fax Number : 301-414-0476
Provider Business Practice Location Address
First Line : 26005 RIDGE RD STE 200
Second Line :
City : DAMASCUS
State : MD
Zip : 20872-1899
Country : US
Telephone Number : 301-414-2305
Fax Number : 301-414-0476
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 02/26/2019

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Directions to “ DR. LIMA LORREN REDHEAD MD” Practice Location

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