Mr. Jack R. Lichtenstein MD - Internal Medicine Physician in Annapolis, Maryland | ProviderWire

Full Name

Mr. Jack R Lichtenstein MD

NPI Number

1609844224

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/09/2006

Specialties

(Taxonomies)

Name

Internal Medicine Physician

Rheumatology Physician

Code

207R00000X

207RR0500X

Primary Taxonomy

Yes

No

Licenses

State

Maryland

License Number

D08194

Contact
Information

Purpose

Mailing

Location

Address

205 RIDGELY AVE

205 RIDGELY AVE

City

Annapolis

Annapolis

State

MD

MD

Postal Code

21401

21401

Country

US

US

Telephone Number

(410) 263-6910

(410) 263-6910

Identifiers

Identifier

J1740003

3304001

Identifier State

DC

MD

Identifier Issuer

CAREFIRST

CAREFIRST

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/21/2008

Provider Address

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