Healthcare Provider Details

I. General information

NPI: 1336185982
Provider Name (Legal Business Name): DR. DARLENE LAWRENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MASSACHUSETTS AVE SE BUILDING 29
WASHINGTON DC
20003-2542
US

IV. Provider business mailing address

1530 GALLATIN PL NE
WASHINGTON DC
20017-3101
US

V. Phone/Fax

Practice location:
  • Phone: 202-548-6500
  • Fax: 202-548-7526
Mailing address:
  • Phone: 202-526-2121
  • Fax: 202-526-1615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19991
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: