Individual
LISA MARIE HALVORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
703 NEW MARK ESPLANADE, ROCKVILLE, MD 20850-2739
(214) 288-1960
Mailing address
703 NEW MARK ESPLANADE, ROCKVILLE, MD 20850-2739
(214) 288-1960
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
D0078686
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155350501
—
TX
Enumeration date
05/12/2006
Last updated
12/19/2016
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