Individual
DR. LYSA CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST, KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Mailing address
2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST, KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
D0053807
MD
Other
Enumeration date
11/01/2006
Last updated
06/03/2021
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