Healthcare Provider Details

I. General information

NPI: 1437655479
Provider Name (Legal Business Name): MARIA MAGDALENA LAWRYNOWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 06/25/2021
Certification Date: 06/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW DEPT OF
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

25500 POINT LOOKOUT RD
LEONARDTOWN MD
20650-2015
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-8080
  • Fax: 202-877-7633
Mailing address:
  • Phone: 301-475-8981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD91022
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: