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General NPI Number Information
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NPI Number | 1215918248
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Entity Type | Individual
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Provider Name | LACYONI MORAES-FINGLASS MD
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Gender | Female
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 1237 W MAIN ST
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City | ABINGDON
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State | VA
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Zip | 24210-4705
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Country | US
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Telephone | 276-676-2211
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Fax |
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Provider Business Mailing Address
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Address Line | 19332 TRIPLE CROWN DR
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City | ABINGDON
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State | VA
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Zip | 24211-6752
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Country | US
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Telephone | 276-676-3969
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Fax |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101225620
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License Number State | VA
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