Provider Demographics
NPI:1033226253
Name:CONGER, LAWRENCE KENDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:KENDALL
Last Name:CONGER
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 1:422 MARLOWE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7018
Mailing Address - Country:US
Mailing Address - Phone:919-633-8397
Mailing Address - Fax:
Practice Address - Street 1:8010 ARCO CORPORATE PKWY
Practice Address - Street 2:SCHWARZ BIOSCIENCES
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-2011
Practice Address - Country:US
Practice Address - Phone:919-633-8397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21686207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5906497Medicaid
NC5906497Medicaid
NC20652874Medicare PIN