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Individual

LAWRENCE J WASSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-6000
(502) 852-4989
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 629-6000
(502) 852-4989

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20466
KY
208000000X
Pediatrics Physician
Primary
20466
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100463670
IN
05
64204662
KY
Enumeration date
12/19/2005
Last updated
09/05/2014
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