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Individual

DR. LAWRENCE B COLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6261 E VIRGINIA BEACH BLVD, SUITE 100, NORFOLK, VA 23502-2964
(757) 466-1000
(757) 466-7788
Mailing address
6261 E VIRGINIA BEACH BLVD, SUITE 100, NORFOLK, VA 23502-2964
(757) 466-1000
(757) 466-7788

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
0101044977
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0016493775
VA SALES TAX NUMBER
05
006900151
VA
01
0101044977
VA LICENSE
VA
01
024565
BCBS
01
15781
SENTARA
01
2218489
AETNA
01
24004907
RAILROAD MEDICARE
01
295242
BCBS
VA
01
295243
BCBS
VA
01
3755
ASPRS
01
541706870
TAX ID
05
890686C
NC
01
C08782
MEDICARE GROUP
Enumeration date
08/31/2006
Last updated
03/07/2023
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