Individual
DR. MARISA LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD PC
Contact information
Practice address
980 JOHNSON FY RD NE STE 110, ATLANTA, GA 30342-1607
(404) 303-7004
(404) 303-7020
Mailing address
980 JOHNSON FY RD NE STE 110, ATLANTA, GA 30342-1607
(404) 303-7004
(404) 303-7020
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
38839
GA
174400000X
Specialist
582261832
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582261832
TAX ID
GA
Enumeration date
09/28/2006
Last updated
03/20/2024
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