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Individual

DR. WALTER J LAWRENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
551 GLOVER AVE, ENTERPRISE, AL 36330-2041
(334) 475-2058
(334) 489-4308
Mailing address
551 GLOVER AVE, ENTERPRISE, AL 36330-2041
(334) 475-2058
(334) 489-4308

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25503
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009975885
AL
01
51000284
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/06/2006
Last updated
03/17/2018
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