Healthcare Provider Details

I. General information

NPI: 1588826499
Provider Name (Legal Business Name): LYNDAL RAY EMERSON M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRAMC BLDG 2 DEPARTMENT OF PSYCHIATRY 6900 GEORGIA AVE NW
WASHINGTON DC
20307-0001
US

IV. Provider business mailing address

WRAMC BLDG 2 RM 2J38 6900 GEORGIA AVE. NW
WASHINGTON DC
20307-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-9731
  • Fax:
Mailing address:
  • Phone: 202-782-9731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: