LISA RENFRO MD PA NPI 1245355999

NPI Information

LISA RENFRO MD PA is a medical physician assistant in Annapolis, MD. LISA RENFRO MD PA NPI is 1245355999. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Annapolis Dermatology Associates.

The provider's business location address is:

2002 MEDICAL PKWY
SUITE 630
ANNAPOLIS, MD
ZIP 21401-046
Phone: (410) 224-2260
Fax: (410) 224-3090

The provider's authorized official is Lisa J Renfro .
The authorized official title is Owner Physician and has the following contact phone number (410) 224-5700.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 10/16/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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