Provider Demographics
NPI:1790812469
Name:HE, LILI (OMD)
Entity Type:Individual
Prefix:DR
First Name:LILI
Middle Name:
Last Name:HE
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 LIBERTY RD BLDG II
Mailing Address - Street 2:COUNTRY VILLAGE
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6602
Mailing Address - Country:US
Mailing Address - Phone:410-795-2205
Mailing Address - Fax:410-795-0026
Practice Address - Street 1:1912 LIBERTY RD BLDG II COUNTRY VILLAGE
Practice Address - Street 2:CARROLL ACUPUNCTURE CLINIC
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6602
Practice Address - Country:US
Practice Address - Phone:410-795-2205
Practice Address - Fax:410-795-0026
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01474171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist