Organization
LAKESIDE MEDICAL GROUP-DR. RAJ CHAWLA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJ CHAWLA M.D. (PRESIDENT)
(301) 809-6494
Entity
Organization
Contact information
Practice address
14300 GALLANT FOX LN STE 210, BOWIE, MD 20715-4033
(301) 809-5556
(301) 809-5510
Mailing address
14300 GALLANT FOX LN STE 205, BOWIE, MD 20715-4033
(301) 809-6494
(301) 809-6497
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407439400
—
MD
Enumeration date
12/14/2006
Last updated
07/21/2022
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