Provider Demographics
NPI:1881811172
Name:MUNDEY, LYNETTE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:LYNETTE
Middle Name:ELIZABETH
Last Name:MUNDEY
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 1:405 U ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2332
Mailing Address - Country:US
Mailing Address - Phone:202-806-7559
Mailing Address - Fax:202-806-7416
Practice Address - Street 1:2139 GEORGIA AVE NW
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-0001
Practice Address - Country:US
Practice Address - Phone:202-805-7559
Practice Address - Fax:202-806-7416
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD12922207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine