Individual
DR. LAWRENCE LOTTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11141 PARKVIEW PLAZA DR, SUITE 305, FORT WAYNE, IN 46845-1713
(800) 633-5331
(260) 266-2009
Mailing address
1234 E DUPONT RD, SUITE 1, FORT WAYNE, IN 46825-1545
(260) 373-7854
(260) 458-5664
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
ME27008
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039175100
—
FL
Enumeration date
06/21/2006
Last updated
07/21/2015
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