Healthcare Provider Details

I. General information

NPI: 1063689982
Provider Name (Legal Business Name): VICTORIA ANN LILLING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 MONTROSE RD STE 340
POTOMAC MD
20854-3363
US

IV. Provider business mailing address

7811 MONTROSE RD STE 340
POTOMAC MD
20854-3363
US

V. Phone/Fax

Practice location:
  • Phone: 301-588-7888
  • Fax: 301-588-3419
Mailing address:
  • Phone: 301-588-7888
  • Fax: 301-588-3419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0075777
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberD0075777
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: