Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301022261 | MI |
NPI | 1255321287 |
---|---|
Provider Name | Dr. Lawrence C Sweet |
First Address | Southfield, MI 48076-1113 |
Second Address | Southfield, MI 48076-1113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 03/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B44693 | (02) |