Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 072369 | GA |
N | 207XS0106X | Orthopaedic Hand Surgeon | 072369 | GA |
NPI | 1316169220 |
---|---|
Provider Name | Melissa Marie Lawrence |
First Address | Albany, GA 31721-1514 |
Second Address | Albany, GA 31721-1514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 12/04/2021 |