Individual
RICHARD BRIAN LAWDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 W FARIS RD, GREENVILLE, SC 29605-4444
(864) 295-4410
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6303
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
13829
SC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
13829
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138292
—
SC
01
—
P00821906
RAILROAD MEDICARE
SC
Enumeration date
01/30/2006
Last updated
01/25/2018
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