Individual
LAWRENCE ALLEN HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7445 ALLEN RD, SUITE 190, ALLEN PARK, MI 48101-1993
(313) 382-2184
(313) 382-2189
Mailing address
7445 ALLEN RD, SUITE 190, ALLEN PARK, MI 48101-1993
(313) 382-2184
(313) 382-2189
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301407500
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0825978
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/04/2007
Last updated
02/14/2008
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