Individual
LACHELLE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
504 E RIDGEVILLE BLVD STE 120, MOUNT AIRY, MD 21771-5942
(240) 215-6370
Mailing address
13540 HULL STREET RD, MIDLOTHIAN, VA 23112-2107
(804) 739-6142
(804) 739-8923
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101252713
VA
207Q00000X
Family Medicine Physician
2011-01176
NC
207Q00000X
Family Medicine Physician
Primary
D86104
MD
390200000X
Student in an Organized Health Care Education/Training Program
BP10030920
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C09633
GROUP PTAN
VA
Enumeration date
08/08/2008
Last updated
04/30/2019
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