Provider Demographics
NPI:1437255932
Name:LORBIECKI, LAWRENCE J III (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:LORBIECKI
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:927 CHURCHILL ST W
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6605
Mailing Address - Country:US
Mailing Address - Phone:651-430-8537
Mailing Address - Fax:651-430-4646
Practice Address - Street 1:1500 CURVE CREST BLVD W
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6040
Practice Address - Country:US
Practice Address - Phone:651-439-1234
Practice Address - Fax:651-351-0827
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN33799207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31966200Medicaid
WI31966200Medicaid
MNE89606Medicare UPIN