Individual
THEODORE S LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301050925
MI
207RX0202X
Medical Oncology Physician
4301050925
MI
2085R0001X
Radiation Oncology Physician
Primary
4301050925
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3453959
—
MI
Enumeration date
09/29/2006
Last updated
04/13/2020
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