Provider Demographics
NPI:1558628677
Name:SANN, LAWRENCE L (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:L
Last Name:SANN
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:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-6400
Mailing Address - Fax:515-643-5816
Practice Address - Street 1:411 LAUREL ST STE 3250
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3026
Practice Address - Country:US
Practice Address - Phone:515-643-6400
Practice Address - Fax:515-643-5816
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT56317208600000X, 2086S0102X
390200000X
IAMD-478792086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program