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Individual

MICHAEL T. LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1501 W MOUNT ROYAL AVE, BALTIMORE, MD 21217-4247
(410) 225-8855
Mailing address
PO BOX 64522, BALTIMORE, MD 21264-4522
(410) 225-8000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0051148
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080191606
RR MEDICARE
05
114800100
MD
01
220540006
JAI MCO
MD
01
54139
COVENTRY HEALTHCARE OF DE
DE
01
K760
BCBS MD
MD
Enumeration date
11/14/2006
Last updated
04/16/2008
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