Provider Demographics
NPI:1437284882
Name:LAWRENCE, ROBERT WM (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WM
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4951 E COUNTY ROAD 40
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-9008
Mailing Address - Country:US
Mailing Address - Phone:970-472-0700
Mailing Address - Fax:970-498-8547
Practice Address - Street 1:4951 E COUNTY ROAD 40
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-9008
Practice Address - Country:US
Practice Address - Phone:970-472-0700
Practice Address - Fax:970-498-8547
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO202132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20213OtherSTATE LICENSE
COEO6349OtherPIN
CO20213OtherSTATE LICENSE