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Individual

LAWRENCE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
735 WILSON ST, BREWER, ME 04412-1000
(207) 992-2601
(207) 989-2280
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD12226
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010474554
MEDNET
ME
01
017716
ANTHEM BC BS
ME
01
1044064
AETNA
ME
05
319680099
ME
01
D78793
HARVARD PLIGRIM HEALTHCAR
ME
01
M61771
CIGNA HEALTHCARE
ME
Enumeration date
08/05/2006
Last updated
08/15/2012
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