Provider Demographics
NPI:1225082886
Name:WEAN, LAWRENCE PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:PAUL
Last Name:WEAN
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 1:605 E BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1734
Mailing Address - Country:US
Mailing Address - Phone:610-891-9640
Mailing Address - Fax:610-891-9644
Practice Address - Street 1:605 E BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1734
Practice Address - Country:US
Practice Address - Phone:610-891-9640
Practice Address - Fax:610-891-9644
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025249E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine