Provider Demographics
NPI:1003850611
Name:AN, LAWRENCE CHIN-I (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:CHIN-I
Last Name:AN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-936-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40857207R00000X
MI4301057790207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN06G47ANOtherBCBS
MN1016609OtherPREFERRED ONE
MNHP29849OtherHEALTHPARTNERS
MN8036109OtherARAZ
MN124694OtherUCARE
MN952824500Medicaid
MN04-08407OtherMEDICA CHOICE & PRIMARY
IA0176446Medicaid
MIG06660Medicare UPIN
MNHP29849OtherHEALTHPARTNERS