Provider Demographics
NPI:1285012468
Name:PERZ, LAUREN MARIE (DO)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:PERZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MARIE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:23511 HOLLYWOOD ROAD
Mailing Address - Street 2:SUITE 2, PO BOX 909
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650
Mailing Address - Country:US
Mailing Address - Phone:301-997-0611
Mailing Address - Fax:855-253-1610
Practice Address - Street 1:23511 HOLLYWOOD RD STE 2
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-5833
Practice Address - Country:US
Practice Address - Phone:301-997-0611
Practice Address - Fax:855-253-1610
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0085654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine