Provider Demographics
NPI:1578535142
Name:MORAWA, LAWRENCE G (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:G
Last Name:MORAWA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1560 E MAPLE RD
Mailing Address - Street 2:SUITE 400 - CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1138
Mailing Address - Country:US
Mailing Address - Phone:313-438-7970
Mailing Address - Fax:313-438-7975
Practice Address - Street 1:18100 OAKWOOD BLVD
Practice Address - Street 2:300
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4085
Practice Address - Country:US
Practice Address - Phone:313-438-7970
Practice Address - Fax:313-438-7975
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2017-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301028224207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1551852-10Medicaid
MIB43948Medicare UPIN
MI0P30630589Medicare PIN