Individual
DR. LEE JAMES LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1109 N MAYFAIR RD, SUITE 208, WAUWATOSA, WI 53226-3430
(414) 771-3618
(414) 290-6755
Mailing address
16875 VANDERBILT ST, BROOKFIELD, WI 53005-2777
(262) 352-8299
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
29649-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31431300
—
WI
01
—
930043564
MEDICARE RAILROAD
WI
01
—
P00273828
MEDICARE RAILROAD
WI
Enumeration date
06/27/2006
Last updated
01/23/2013
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