Healthcare Provider Details

I. General information

NPI: 1639339864
Provider Name (Legal Business Name): TRACY LO SUYI MEYER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACY SUYI LO M.D.

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4228 WISCONSIN AVE NW
WASHINGTON DC
20016
US

IV. Provider business mailing address

4228 WISCONSIN AVE. NW
WASHINGTON DC
20016
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-5076
  • Fax:
Mailing address:
  • Phone:
  • 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 Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD038791
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD038791
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: