Individual
DARYL M LAWRENCE-FRIEDL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
877 FOREST HILL AVE., SE,, SUITE C, GRAND RAPIDS, MI 49546-2380
(616) 954-0402
(616) 954-0404
Mailing address
877 FOREST HILL AVE., SE,, SUITE C, GRAND RAPIDS, MI 49546-2380
(616) 954-0402
(616) 954-0404
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101010305
MI
207Q00000X
Family Medicine Physician
Primary
5101010305
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D12216
BCBS GROUP
MI
05
—
1639382211
—
MI
01
—
DH2054
RR MEDICARE
MI
Enumeration date
04/19/2006
Last updated
05/02/2012
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