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General NPI Number Information
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NPI Number | 1073601035
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Entity Type | Individual
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Provider Name | VIVIAN L LUGO-ESCHENWALD MD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 2000 N BEAUREGARD ST SUITE 330
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1748
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Country | US
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Telephone | 703-370-2400
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Fax | 703-370-7214
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Provider Business Mailing Address
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Address Line | PO BOX 17334
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City | BALTIMORE
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State | MD
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Zip | 21297-1334
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Country | US
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Telephone | 703-443-6717
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Fax | 703-443-8643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101049923
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License Number State | VA
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