Individual
LAWRENCE KONICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
665 WINTER STREET, SALEM, OR 97301-3934
(503) 561-5564
(503) 561-4781
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
MD-17760
OR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD17760
OR
Other
Enumeration date
12/13/2006
Last updated
04/15/2016
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