Provider Demographics
NPI:1063636447
Name:LAFEVER, ALICE MARIANNE (MD)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:MARIANNE
Last Name:LAFEVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 JENNINGS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-7822
Mailing Address - Country:US
Mailing Address - Phone:410-489-9342
Mailing Address - Fax:
Practice Address - Street 1:2716 JENNINGS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:MD
Practice Address - Zip Code:21797-7822
Practice Address - Country:US
Practice Address - Phone:410-489-9342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDO023789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB67272Medicare UPIN