Provider Demographics
NPI:1366400186
Name:LAHOM, LAUDELINA (MD)
Entity type:Individual
Prefix:DR
First Name:LAUDELINA
Middle Name:
Last Name:LAHOM
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 1:8900 COLUMBIA 100 PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2336
Mailing Address - Country:US
Mailing Address - Phone:410-997-6464
Mailing Address - Fax:410-997-6867
Practice Address - Street 1:8900 COLUMBIA 100 PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2336
Practice Address - Country:US
Practice Address - Phone:410-997-6464
Practice Address - Fax:410-997-6867
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018905174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist