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Organization
KENNETH R LAWRENCE DPM PC
Active
Organization
KENNETH R LAWRENCE DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH RICHARD LAWRENCE (PHYSICIAN)
(248) 476-1616
Entity
Organization
Contact information
Practice address
30335 W 13 MILE RD STE 100, FARMINGTON HILLS, MI 48334
(248) 476-1616
(248) 476-6683
Mailing address
24300 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48336-1935
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480009796
MEDICARE RR PIN
MI
01
—
CA5369
MEDICARE B RAILROAD
MI
Enumeration date
10/27/2006
Last updated
05/29/2018
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