Basic Information
| Provider Information | |||||||||
| NPI: | 1326129446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDSAY | ||||||||
| FirstName: | BEVERLY | ||||||||
| MiddleName: | LORRAINE- ARCHER | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ARCHER | ||||||||
| OtherFirstName: | BEVERLY | ||||||||
| OtherMiddleName: | LORRAINE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 12305 CHAGALL DRIVE | ||||||||
| Address2: | |||||||||
| City: | NORTH POTOMAC | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015908152 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2480 LLEWELLYN AVE | ||||||||
| Address2: | |||||||||
| City: | FORT MEADE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207557081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016778800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 05/23/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | D0040788 | MD | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.