Provider Demographics
NPI:1386839181
Name:LAWRENCHUK, DONALD W (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:W
Last Name:LAWRENCHUK
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 E GRAND RIVER AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7574
Mailing Address - Country:US
Mailing Address - Phone:517-552-6830
Mailing Address - Fax:
Practice Address - Street 1:2300 E GRAND RIVER AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7574
Practice Address - Country:US
Practice Address - Phone:517-552-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301044229251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4798737Medicaid
MI4798737Medicaid