Provider Demographics
NPI:1982823977
Name:AMDURSKY, LOREN J (MD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:J
Last Name:AMDURSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5480 WISCONSIN AVE.
Mailing Address - Street 2:#227
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3500
Mailing Address - Country:US
Mailing Address - Phone:301-806-7695
Mailing Address - Fax:301-349-3240
Practice Address - Street 1:5480 WISCONSIN AVE.
Practice Address - Street 2:227
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3500
Practice Address - Country:US
Practice Address - Phone:301-806-7695
Practice Address - Fax:301-349-3240
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0336602084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry