Individual
DR. LAWRENCE N EISENMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DIV NEUROLOGY ADULT, STE 6C, SAINT LOUIS, MO 63110-1032
(314) 362-1408
(314) 747-8427
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-1408
(314) 747-8427
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
Primary
115434
MO
2084N0400X
Neurology Physician
115434
MO
2084N0600X
Clinical Neurophysiology Physician
115434
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205999402
—
MO
Enumeration date
07/14/2006
Last updated
04/17/2025
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