Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 8069 | AZ |
NPI | 1386744076 |
---|---|
Provider Name | Michael A Lawson |
First Address | Phoenix, AZ 85016-2707 |
Second Address | Phoenix, AZ 85020-4327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E45429 | (02) | AZ |