Individual
DR. LISA DANG LAROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(240) 612-2020
(240) 612-3880
Mailing address
MALCOLM GROW MEDICAL CLINICS AND SURGERY CENTER, 1060 W. PERIMETER RD, JB ANDREWS, MD 20762
(240) 612-2020
(240) 612-3880
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
0101254304
VA
2085R0202X
Diagnostic Radiology Physician
Primary
0101254304
VA
208D00000X
General Practice Physician
0101254304
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2011
Last updated
08/04/2023
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