Provider Demographics
NPI:1316952039
Name:LEMMONS, KARENGA R (MD)
Entity type:Individual
Prefix:
First Name:KARENGA
Middle Name:R
Last Name:LEMMONS
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 1:301 STEEPLE CHASE DR
Mailing Address - Street 2:STE 103
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4049
Mailing Address - Country:US
Mailing Address - Phone:410-414-5633
Mailing Address - Fax:410-414-5911
Practice Address - Street 1:301 STEEPLE CHASE DR
Practice Address - Street 2:STE 103
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4049
Practice Address - Country:US
Practice Address - Phone:410-414-5633
Practice Address - Fax:410-414-5911
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0031711174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
B69596Medicare UPIN