Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 25245 | LA |
NPI | 1174534697 |
---|---|
Provider Name | Julia Ann Lawrence |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 27/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1131849 | (05) | LA |
1174534697 | (05) | VA |
143T8 | BCBS (01) | |
192387 | MEDCOST (01) | |
3810007277 | (05) | WV |
5905973 | (05) | NC |
7592181 | AETNA (01) | |
808462 | PARTNERS (01) | |
F24021 | (02) | |
Q0157F | (05) | SC |