Provider Demographics
NPI:1588627830
Name:SHULMAN, LAWRENCE NATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:NATHAN
Last Name:SHULMAN
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 1:3400 SPRUCE ST
Mailing Address - Street 2:2 SILVERSTEIN
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-615-5858
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:2 SILVERSTEIN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-615-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI40661207RH0003X
PAMD455843207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0441603OtherUNITED HEALTH CARE
63930OtherFALLON COMMUNITY HEALTH P
0134708OtherMASSHEALTH MA MEDICAID
MAC16135OtherBCBS INDEMITY BC ELECT HM
2067469OtherAETNA US HEALTHCARE
900001632OtherRR MEDICARE DFCI
9817877OtherCIGNA
B73497DFOtherHPHC DFCI ONLY
729852OtherTUFTS
729852OtherTUFTS
2067469OtherAETNA US HEALTHCARE