Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 0101243981 | VA |
Y | 207L00000X | Anesthesiologist | D86639 | MD |
NPI | 1013114636 |
---|---|
Provider Name | Dr. Michelle Pham Lawrence |
First Address | Portsmouth, VA 23708-2111 |
Second Address | Silver Spring, MD 20910-1460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 13/02/2019 |