Individual
DR. DAVID LAWLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, PEDIATRIC SURGERY WRN 11, BOSTON, MA 02114-2696
(617) 726-8858
(617) 726-2167
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-8858
(617) 726-2167
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
74011
MA
2086S0120X
Pediatric Surgery Physician
Primary
74011
MA
2086S0120X
Pediatric Surgery Physician
74015
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101524
—
MA
01
—
074011
TUFTS HEALTH PLAN
MA
01
—
J22667
BCBS MA
MA
Enumeration date
12/20/2005
Last updated
12/11/2024
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