Individual
DR. MALLORY ANDREW LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1348 WALTON WAY, SUITE 6500, AUGUSTA, GA 30901-5104
(706) 722-2118
(706) 722-0342
Mailing address
1348 WALTON WAY, SUITE 6500, AUGUSTA, GA 30901-5104
(706) 722-2118
(706) 722-0342
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
026578
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00399517A
—
GA
01
—
1621144003
CIGNA
GA
01
—
1621144004
CIGNA HMO
GA
01
—
2089751
AETNA HMO
GA
01
—
4140381
AETNA
GA
05
—
G26578
—
SC
Enumeration date
10/23/2006
Last updated
02/15/2010
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