Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | C20007648 | DE |
N | 208600000X | Surgeon | C20007648 | DE |
Y | 2086S0129X | Vascular Surgeon | OS010450L | PA |
NPI | 1093726101 |
---|---|
Provider Name | Dr. Matthew W Lawrence |
First Address | Somers Point, NJ 08244 |
Second Address | Somers Point, NJ 08244-2449 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 02/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0712591 | (05) | NJ |
1000035617 | (05) | DE |
1013649230003 | (05) | PA |
I25106 | (02) |