Individual
MRS. LA VERGNE ANDRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
14202 LAKE RUN CT, BOWIE, MD 20720-4861
(301) 323-5652
(410) 740-2412
Mailing address
14202 LAKE RUN CT, BOWIE, MD 20720-4861
(301) 323-5652
(410) 740-2412
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1101
MD
Other
Enumeration date
04/10/2008
Last updated
09/06/2011
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