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La Vergne Andre, DPM

Podiatrist in Bowie, MD. Individual provider (NPI-1).

NPI number1447423397
StatusActive
Last updated in NPPESSep 6, 2011

Details

NPI
1447423397
Entity type
Individual (NPI-1)
Name
Mrs. La Vergne Andre
Credential
DPM
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 10, 2008
Last updated
Sep 6, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213E00000X Podiatrist1101MDYes

Practice location

14202 Lake Run Ct
Bowie, MD 20720-4861

Phone 301-323-5652 · Fax 410-740-2412

Mailing address

14202 Lake Run Ct
Bowie, MD 20720-4861

Phone 301-323-5652 · Fax 410-740-2412

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