Provider Demographics
NPI:1629242680
Name:LATTIMER, LAKSHMI DEVI NELSON (MD)
Entity Type:Individual
Prefix:
First Name:LAKSHMI
Middle Name:DEVI NELSON
Last Name:LATTIMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAKSHMI
Other - Middle Name:DEVI
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6501 LOISDALE CT STE 1100
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1885
Mailing Address - Country:US
Mailing Address - Phone:703-922-1313
Mailing Address - Fax:
Practice Address - Street 1:6501 LOISDALE CT STE 1100
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1885
Practice Address - Country:US
Practice Address - Phone:703-922-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD040499207RG0100X
VA0101253015207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology