Provider Demographics
NPI:1457350654
Name:MCINTOSH, LASHAUNA (MD)
Entity Type:Individual
Prefix:DR
First Name:LASHAUNA
Middle Name:
Last Name:MCINTOSH
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:PO BOX 824804
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-4804
Mailing Address - Country:US
Mailing Address - Phone:302-691-3800
Mailing Address - Fax:302-778-2250
Practice Address - Street 1:620 STANTON CHRISTIANA RD STE 304
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2135
Practice Address - Country:US
Practice Address - Phone:302-778-2229
Practice Address - Fax:302-778-2250
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0005392207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G80020Medicare UPIN
G00440Medicare PIN
G00440Medicare PIN