Organization
LISA RENFRO MD PA
Active
Organization
LISA RENFRO MD PA
Active
Other names
ANNAPOLIS DERMATOLOGY ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA J RENFRO MD (OWNER PHYSICIAN)
(410) 224-5700
Entity
Organization
Contact information
Practice address
2002 MEDICAL PKWY, SUITE 630, ANNAPOLIS, MD 21401-3046
(410) 224-2260
(410) 224-3090
Mailing address
2002 MEDICAL PKWY, SUITE 630, ANNAPOLIS, MD 21401-3046
(410) 224-2260
(410) 224-3090
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0002046
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306820626
NPI
—
01
—
1568545515
NPI
—
01
—
1780772707
NPI
—
Enumeration date
03/20/2007
Last updated
10/16/2007
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