Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704263271 | MI |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 4704263271 | MI |
NPI | 1003247826 |
---|---|
Provider Name | Donald Lawson JR. |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-4213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2013 |
Last Update Date | 26/12/2018 |