1891729976 NPI number — DAVID MICHAEL LAWRENCE DPM

Table of content: DAVID MICHAEL LAWRENCE DPM (NPI 1891729976)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891729976 NPI number — DAVID MICHAEL LAWRENCE DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAWRENCE
Provider First Name:
DAVID
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891729976
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85 BEACH STREET
Provider Second Line Business Mailing Address:
BLDG C
Provider Business Mailing Address City Name:
WESTERLY
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02891
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-596-0823
Provider Business Mailing Address Fax Number:
401-596-2960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 BEACH STREET
Provider Second Line Business Practice Location Address:
BLDG C
Provider Business Practice Location Address City Name:
WESTERLY
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02891
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-596-0823
Provider Business Practice Location Address Fax Number:
401-596-2960
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  DPM00225 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 213E00000X , with the licence number: 000428 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 030000428CT01 . This is a "ANTHEM OF CT" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 030881 . This is a "HEALTH NET" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 030881 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2700176 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 480033446 . This is a "METRAHEALTH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 480033446 . This is a "METRAHEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 708699 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 030881 . This is a "HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: CJ6759 . This is a "RR MEDICARE GROUP PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030000225RI01 . This is a "ANTHEM" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 050448699 . This is a "UNITED HEALTHCARE OTHER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201484 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 050448699 . This is a "TRICARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 050448699 . This is a "TRICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1467574475 . This is a "GROUP NPI FOR DAVID LAWRENCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 480033446 . This is a "RR MEDICARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 708699 . This is a "CONNECTICARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: P795857 . This is a "OXFORD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 489007028 . This is a "BLUE CROSS OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com