Provider Demographics
NPI:1982878997
Name:KARENGA R LEMMONS, M.D., L.L.C.
Entity Type:Organization
Organization Name:KARENGA R LEMMONS, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARENGA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-497-9490
Mailing Address - Street 1:9811 MALLARD DR
Mailing Address - Street 2:STE 211
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3143
Mailing Address - Country:US
Mailing Address - Phone:301-497-9490
Mailing Address - Fax:301-497-9493
Practice Address - Street 1:9811 MALLARD DR
Practice Address - Street 2:STE 211
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3143
Practice Address - Country:US
Practice Address - Phone:301-497-9490
Practice Address - Fax:301-497-9493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0031711174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD444591100Medicaid