Organization
LAWRENCE G. KIDD M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE G KIDD M.D. (PRESIDENT)
(978) 682-3686
Entity
Organization
Contact information
Practice address
25 MARSTON ST, STE 401, LAWRENCE, MA 01841-2310
(978) 682-3686
(978) 794-0841
Mailing address
25 MARSTON ST, STE 401, LAWRENCE, MA 01841-2310
(978) 682-3686
(978) 794-0841
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RI0200X
Infectious Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110069548A
—
MA
01
—
M13869
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/12/2006
Last updated
06/23/2014
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