Provider Demographics
NPI:1033389671
Name:LAWSON, HERSCHEL W (MD)
Entity Type:Individual
Prefix:DR
First Name:HERSCHEL
Middle Name:W
Last Name:LAWSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4770 BUFORD HWY
Mailing Address - Street 2:MS K-57
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-3717
Mailing Address - Country:US
Mailing Address - Phone:770-488-4880
Mailing Address - Fax:770-488-3230
Practice Address - Street 1:4770 BUFORD HWY
Practice Address - Street 2:MS K-57
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-3717
Practice Address - Country:US
Practice Address - Phone:770-488-4880
Practice Address - Fax:770-488-3230
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA032228207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8241630OtherNSHS
WA8241630OtherNSHS
WAAB05812Medicare PIN