Provider Demographics
NPI:1508818824
Name:BIEL, LAWRENCE WARREN (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:WARREN
Last Name:BIEL
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 1:967 SOUTH LAKE STREET
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-2616
Mailing Address - Country:US
Mailing Address - Phone:651-464-1113
Mailing Address - Fax:651-454-0853
Practice Address - Street 1:967 SOUTH LAKE STREET
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2616
Practice Address - Country:US
Practice Address - Phone:651-464-1113
Practice Address - Fax:651-454-0853
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN27297208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA95861Medicare UPIN