Provider Demographics
NPI:1235609876
Name:LAWSON, EDWARD BRUCE
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:BRUCE
Last Name:LAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8687 GREENBELT RD APT T2
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770
Mailing Address - Country:US
Mailing Address - Phone:240-619-0382
Mailing Address - Fax:
Practice Address - Street 1:3400 BANNEKER DR 425
Practice Address - Street 2:
Practice Address - City:NORTHEAST
Practice Address - State:DC
Practice Address - Zip Code:20001
Practice Address - Country:US
Practice Address - Phone:240-217-0832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant