Individual
DR. SUSAN LACKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2141 K STREET NW, SUITE 407, WASHINGTON, DC 20037-1810
(202) 293-8815
(202) 293-4118
Mailing address
2141 K STREET NW, SUITE 407, WASHINGTON, DC 20037-1810
(202) 293-8815
(202) 293-4118
Taxonomy
Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
Primary
13189
DC
207RR0500X
Rheumatology Physician
13189
DC
Other
Enumeration date
08/27/2006
Last updated
08/17/2010
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