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Individual

LAWRENCE M WYNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1115 20TH ST, SUITE 107, HUNTINGTON, WV 25703-2071
(304) 691-1900
(304) 691-1929
Mailing address
1115 20TH STREET, SUITE 107, HUNTINGTON, WV 25703
(304) 691-1900
(304) 691-1929

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
16680
WV
208800000X
Urology Physician
35059870
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0130195000
WV
Enumeration date
12/05/2006
Last updated
11/18/2021
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