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Individual

MR. LAWRENCE WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606
Mailing address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R1K80
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669430112
MO
Enumeration date
05/03/2006
Last updated
11/12/2015
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