Organization
LAWRENCE DESJARLAIS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE JOHN DESJARLAIS MD (PHYSICIAN.OWNER)
(517) 264-5603
Entity
Organization
Contact information
Practice address
2000 CURTIS RD, ADRIAN, MI 49221-1752
(517) 264-5603
(517) 264-5708
Mailing address
2000 CURTIS RD, ADRIAN, MI 49221-1752
(517) 264-5603
(517) 264-5708
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301058635
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0704603132
BCBSOF MICHIGAN
MI
05
—
3109892
—
MI
Enumeration date
11/21/2007
Last updated
08/20/2012
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