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Individual

BRIAN C LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAAA

Contact information

Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-0000
(678) 514-1991
(678) 514-1992
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(954) 839-2569

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
003903
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100002166A
GA
05
100002166H
GA
Enumeration date
01/19/2006
Last updated
05/22/2013
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