Individual
DR. LAWRENCE MATTHEW MINARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 DONNALLY ST, BLDG B NORTH, CHARLESTON, WV 25301-1648
(304) 343-6219
(304) 343-1423
Mailing address
500 DONNALLY ST, STE 1, CHARLESTON, WV 25301-1600
(304) 343-0331
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11596
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096789000
—
WV
01
—
MI9220052
MEDICARE GROUP NUMBER
WV
Enumeration date
12/07/2005
Last updated
10/27/2016
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