Individual
MICHAEL LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2301 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 585-1000
Mailing address
S66W22285 NATIONAL AVE, WAUKESHA, WI 53189-9660
(414) 238-3859
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1174-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42987200
—
WI
Enumeration date
09/20/2005
Last updated
12/23/2021
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