Provider Demographics
NPI:1063445013
Name:LIFESTYLE MEDICAL CENTER, CHERYL BROWN-CHRISTOPHER M. D., CHARTERED
Entity Type:Organization
Organization Name:LIFESTYLE MEDICAL CENTER, CHERYL BROWN-CHRISTOPHER M. D., CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BROWN-CHRISTOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:202-635-2079
Mailing Address - Street 1:1445 EVARTS ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2015
Mailing Address - Country:US
Mailing Address - Phone:202-635-2079
Mailing Address - Fax:202-526-1865
Practice Address - Street 1:116 DEFENSE HWY STE 200
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7045
Practice Address - Country:US
Practice Address - Phone:410-571-1478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0027848207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK323Medicare ID - Type UnspecifiedMEDICARE
MDD75250Medicare UPIN