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Individual

LAWRENCE G KIDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
25 MARSTON ST, SUITE 401, LAWRENCE, MA 01841-2310
(978) 682-3686
(978) 794-0841
Mailing address
25 MARSTON ST, SUITE 401, LAWRENCE, MA 01841-2310
(978) 682-3686
(978) 794-0841

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
41919
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0107432YPMA01
ANTHEM NH
05
0133957
MA
01
042799825
CIGNA
01
33580
FALLON COMMUNITY HEALTH
01
531260
AETNA
01
66729
HARVARD PILGRIM
01
703254
TUFTS HEALTH PLAN
MA
01
9200058
UNITED HEALTH
01
94070
HEALTHSOURCE
01
D13212
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/16/2006
Last updated
06/23/2014
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