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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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