Healthcare Provider Details
I. General information
NPI: 1558408013
Provider Name (Legal Business Name): SHERYL E LUCAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/31/2007
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 2ND ST NE
WASHINGTON DC
20002-8100
US
IV. Provider business mailing address
2101 EAST JEFFERSON STREET KAISER PERMANENTE PPQA 6 WEST
ROCKVILLE MD
20852
US
V. Phone/Fax
- Phone: 202-346-3500
- Fax: 202-346-3651
- Phone: 301-816-6660
- Fax: 301-816-6308
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | MD11321 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | D0035368 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | 0101042776 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: