Individual
LISA RENEE SUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 ORLEANS ST, ROOM 8444, BALTIMORE, MD 21287-0010
(908) 246-8237
Mailing address
200 N. WOLFE STREET, SUITE 2158, BALTIMORE, MD 21287
(410) 955-4259
(410) 614-2297
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
D81690
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D81690
STATE LICENSE
MD
Enumeration date
01/14/2010
Last updated
11/20/2018
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