Provider Demographics
NPI:1194880849
Name:FUISZ, ALICE LAWRENZ (MD)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:LAWRENZ
Last Name:FUISZ
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 1:1140 19TH ST NW
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-6601
Mailing Address - Country:US
Mailing Address - Phone:202-728-0630
Mailing Address - Fax:
Practice Address - Street 1:1140 19TH ST NW
Practice Address - Street 2:SUITE 500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6601
Practice Address - Country:US
Practice Address - Phone:202-728-0630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 32389207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G07899Medicare UPIN
491869Medicare ID - Type Unspecified