MEDICARE: DR. CHERYL LUNDEBERG LONERGAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0900X	Dermatopathology Physician	D69698	MD
2	207N00000X	Dermatology Physician	D69698	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316169758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL LUNDEBERG LONERGAN M.D.

Provider Business Mailing Address
First Line	:	4201 NORTHVIEW DR STE 200
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2640
Country	:	US
Telephone Number	:	443-637-2888
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 NORTHVIEW DR STE 200
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2640
Country	:	US
Telephone Number	:	443-637-2888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	01/21/2026

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