Individual
LAWRENCE H. NEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2310
(360) 636-4814
(360) 414-7965
Mailing address
PO BOX 249, LONGVIEW, WA 98632-7154
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
MD00044964
WA
2084N0400X
Neurology Physician
Primary
MD00044964
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022559
—
OR
01
—
196953
LABOR & IND.
WA
05
—
8402265
—
WA
01
—
8905955
CRIME VICTIMS
WA
01
—
P00256993
RR MEDICARE
—
Enumeration date
06/20/2005
Last updated
06/12/2014
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