Provider Demographics
NPI:1114966728
Name:LAWRENCE, SALVATORE ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:ANTHONY
Last Name:LAWRENCE
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 1:108 E DRINKER ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2432
Mailing Address - Country:US
Mailing Address - Phone:570-343-2929
Mailing Address - Fax:570-343-2209
Practice Address - Street 1:108 E DRINKER ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-2432
Practice Address - Country:US
Practice Address - Phone:570-343-2929
Practice Address - Fax:570-343-2209
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033044E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C26100Medicare UPIN