MEDICARE: DR. LAURENCE CLUNIE

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	1223G0001X	General Practice Dentistry	DEN2929	DC

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	:	1922118447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURENCE CLUNIE

Provider Business Mailing Address
First Line	:	3310 HEIDI LN
Second Line	:
City	:	SPRINGDALE
State	:	MD
Zip	:	20774-2537
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2811 PENNSYLVANIA AVE SE STE 2
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-3865
Country	:	US
Telephone Number	:	202-584-0710
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	10/01/2013

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Directions to “ DR. LAURENCE CLUNIE ” Practice Location

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