Individual
LAWRENCE A WALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2019 NORMANDIE DR, MONTGOMERY, AL 36111-2711
(334) 281-7523
(334) 281-7912
Mailing address
2019 NORMANDIE DR, MONTGOMERY, AL 36111-2711
(334) 281-7523
(334) 281-7912
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
18712
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23675
BLUE CROSS OF AL
AL
Enumeration date
03/30/2006
Last updated
07/08/2007
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