# LAWRENCE A HANSEN MD PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093930794
- **Authorized official:** DR. LAWRENCE A HANSEN M.D. (MEMBER)
- **Authorized official phone:** (313) 382-0151

## Contact information

- **Practice address:** 7445 ALLEN RD, SUITE 190, ALLEN PARK, MI 48101-1993
- **Practice address phone:** (313) 382-0151
- **Practice address fax:** (313) 382-2189
- **Mailing address:** 7445 ALLEN RD, SUITE 190, ALLEN PARK, MI 48101-1993
- **Mailing address phone:** (313) 382-0151
- **Mailing address fax:** (313) 382-2189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 4301407500 | MI | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 03/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0825978 | BLUE CROSS | MI |