Individual
DR. LAWRENCE G KETTWICH
Active
Individual
DR. LAWRENCE G KETTWICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD2016-0071
NM
207L00000X
Anesthesiology Physician
Primary
MED-PHYS-LIC-55728
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MED-PHYS-LIC-55728
MONTANA MEDICAL LICENSE
MT
Enumeration date
05/03/2012
Last updated
07/21/2022
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