Individual
DR. LAWRENCE A DERENNE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 257-3490
Mailing address
892 CHATHAM LN, COLUMBUS, OH 43221-2419
(614) 538-8634
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-07-4261-D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2177871
—
OH
Enumeration date
06/13/2006
Last updated
07/08/2007
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