Provider Demographics
NPI:1447400312
Name:VAWTER, LEMUEL R (MD)
Entity Type:Individual
Prefix:
First Name:LEMUEL
Middle Name:R
Last Name:VAWTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 OAKDALE AVE N STE 200
Mailing Address - Street 2:MS 33500A-141
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2962
Mailing Address - Country:US
Mailing Address - Phone:763-520-2678
Mailing Address - Fax:
Practice Address - Street 1:3366 OAKDALE AVE N STE 200
Practice Address - Street 2:MS 33500A-141
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2962
Practice Address - Country:US
Practice Address - Phone:763-520-2678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN53668208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist