Provider Demographics
NPI:1619989340
Name:LAWSON, JAMES E (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:LAWSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:11900 TWELVE MILE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093
Mailing Address - Country:US
Mailing Address - Phone:586-558-9033
Mailing Address - Fax:586-573-4209
Practice Address - Street 1:11900 TWELVE MILE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093
Practice Address - Country:US
Practice Address - Phone:586-558-9033
Practice Address - Fax:586-573-4209
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101006328207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1842813Medicaid
A75867Medicare UPIN