# LAWRENCE E TILLEY, MDPA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609044197
- **Authorized official:** DR. LAWRENCE EDWARD TILLEY M.D. (OWNER)
- **Authorized official phone:** (301) 475-8599

## Contact information

- **Practice address:** 23000 MOAKLEY ST, SUITE 203, LEONARDTOWN, MD 20650-2915
- **Practice address phone:** (301) 475-8599
- **Mailing address:** 23000 MOAKLEY ST, SUITE 203, LEONARDTOWN, MD 20650-2915
- **Mailing address phone:** (301) 475-8599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | D28647 | MD | Yes |

## Other

- **Enumeration date:** 02/19/2008
- **Last updated:** 02/19/2008