Individual
MR. WALLACE EDGAR LAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8700 SUDLEY ROAD, MANASSAS, VA 20110-4418
(571) 437-4334
Mailing address
8323 SUFFOLK WAY, GAINESVILLE, VA 20155-1778
(571) 437-4334
(703) 754-3185
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
24116782
VA
367500000X
Certified Registered Nurse Anesthetist
AC000817
MD
Other
Enumeration date
08/29/2006
Last updated
03/07/2011
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