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Individual
LAWRENCE ALLEN HANSEN
Active
Individual
LAWRENCE ALLEN HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301407500
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0825978
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/04/2007
Last updated
02/14/2008
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