1063445013 NPI number — LIFESTYLE MEDICAL CENTER, CHERYL BROWN-CHRISTOPHER M. D., CHARTERED

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063445013 NPI number — LIFESTYLE MEDICAL CENTER, CHERYL BROWN-CHRISTOPHER M. D., CHARTERED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFESTYLE MEDICAL CENTER, CHERYL BROWN-CHRISTOPHER M. D., CHARTERED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063445013
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1445 EVARTS ST NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20018-2015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-635-2079
Provider Business Mailing Address Fax Number:
202-526-1865

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 DEFENSE HWY STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-7045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-571-1478
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN-CHRISTOPHER
Authorized Official First Name:
CHERYL
Authorized Official Middle Name:
DENISE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
202-635-2079

Provider Taxonomy Codes

  • Taxonomy code: 207QG0300X , with the licence number:  D0027848 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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