Provider Demographics
NPI:1497718845
Name:LAWRENCE, DUANE MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:MATTHEW
Last Name:LAWRENCE
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 1:1083 INDEPENDENCE BLVD STE 187
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5523
Mailing Address - Country:US
Mailing Address - Phone:757-910-2270
Mailing Address - Fax:
Practice Address - Street 1:328 OFFICE SQUARE LN STE 104
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3648
Practice Address - Country:US
Practice Address - Phone:757-910-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012385482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry