Provider Demographics
NPI:1033279708
Name:MARTIN, LISA WARSINGER (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:WARSINGER
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:RENEE
Other - Last Name:WARSINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2150 PENNSYLVANIA AVE NW # 4-415
Mailing Address - Street 2:GEORGE WASHINGTON UNIV, CARDIOLOGY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-3201
Mailing Address - Country:US
Mailing Address - Phone:202-741-2323
Mailing Address - Fax:202-741-2324
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW # 4-415
Practice Address - Street 2:GEORGE WASHINGTON UNIV, CARDIOLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3201
Practice Address - Country:US
Practice Address - Phone:202-741-2323
Practice Address - Fax:202-741-2324
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD15396207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
D72283Medicare UPIN
527093M92Medicare ID - Type Unspecified