Individual
DR. LAWRENCE E STROUD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2229 OLD GREENVILLE HWY, PENDLETON, SC 29670
(864) 855-1036
Mailing address
2229 OLD GREENVILLE HWY, PENDLETON, SC 29670-9206
(864) 646-9517
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9099
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090993
—
SC
01
—
110048374
RAILROAD MEDICARE PROV NO
SC
01
—
42D0252876
CLIA NUMBER
SC
01
—
57-0739752
CORP. FEDERAL ID NUMBER
SC
01
—
PA4726
GROUP MEDICAID NUMBER
SC
Enumeration date
09/22/2005
Last updated
04/27/2017
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