Individual
DR. LAWRENCE C MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2920 MCINTYRE DR, SUITE 350, BLOOMINGTON, IN 47403-4221
(812) 332-2226
(812) 339-2934
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
01044093A
IN
207Y00000X
Otolaryngology Physician
Primary
01044093A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200055000
—
IN
01
—
M400056132
MEDICARE PTAN
IN
Enumeration date
11/22/2005
Last updated
09/09/2023
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