Individual
LAWRENCE EDWIN CHANCE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
US HWY 491 NORTH, NORTHERN NAVAJO MEDICAL CENTER, SHIPROCK, NM 87420
(505) 368-6001
(907) 966-8606
Mailing address
PO BOX 160, NORTHERN NAVAJO MEDICAL CENTER, SHIPROCK, NM 87420
(505) 368-6001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
3780
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242390
—
AZ
05
—
45826226
—
CO
05
—
63250233
—
NM
05
—
MD3780
—
AK
Enumeration date
01/12/2007
Last updated
03/31/2008
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