Provider Demographics
NPI:1508158320
Name:REOMA, LAUREN BOWEN (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BOWEN
Last Name:REOMA
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 1:12236 WONDER VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3750
Mailing Address - Country:US
Mailing Address - Phone:561-329-5735
Mailing Address - Fax:
Practice Address - Street 1:NIH CLINICAL CENTER 10 CENTER DRIVE
Practice Address - Street 2:BLDG10 7C103
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20878
Practice Address - Country:US
Practice Address - Phone:301-435-7531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN15932207R00000X
MDD785122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine