Provider Demographics
NPI:1578701678
Name:GINN, LISA ROBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ROBIN
Last Name:GINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5301 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2015
Mailing Address - Country:US
Mailing Address - Phone:202-237-9292
Mailing Address - Fax:202-250-7073
Practice Address - Street 1:3733 VAN NESS ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2225
Practice Address - Country:US
Practice Address - Phone:202-250-7072
Practice Address - Fax:202-250-7073
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034984174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist