Provider Demographics
NPI:1376587386
Name:LAWSON, STEVEN JAMES (PA)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JAMES
Last Name:LAWSON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3239
Mailing Address - Country:US
Mailing Address - Phone:704-323-2000
Mailing Address - Fax:
Practice Address - Street 1:9848 N TRYON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-5512
Practice Address - Country:US
Practice Address - Phone:704-323-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9659363A00000X
WI1443363A00000X
NC0010-02522363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN170734OtherUCARE
MN0119879OtherMEDICA
MN1030268OtherPREFERRED ONE
MN209590400Medicaid
MN293S3LAOtherBLUE CROSS BLUE SHIELD
WI419741000Medicaid
WI491750009OtherMEDICARE
MNHP34529OtherHEALTHPARTNERS
WI203050009OtherMEDICARE
MNHP34529OtherHEALTHPARTNERS
NC0397730028Medicare NSC
NC2762561Medicare PIN