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General NPI Number Information
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NPI Number | 1881811172
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Entity Type | Individual
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Provider Name | LYNETTE ELIZABETH MUNDEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2139 GEORGIA AVE NW SUITE 201
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City | WASHINGTON
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State | DC
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Zip | 20059-0001
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Country | US
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Telephone | 202-805-7559
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Fax | 202-806-7416
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Provider Business Mailing Address
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Address Line | 405 U ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-2332
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Country | US
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Telephone | 202-806-7559
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Fax | 202-806-7416
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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 | MD12922
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License Number State | DC
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