Provider Demographics
NPI:1689617623
Name:SANDERS, LAWRENCE THOMAS (MD)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:THOMAS
Last Name:SANDERS
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 1:276 COUNTY FARM RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-6003
Mailing Address - Country:US
Mailing Address - Phone:603-742-1348
Mailing Address - Fax:603-742-9060
Practice Address - Street 1:276 COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-6003
Practice Address - Country:US
Practice Address - Phone:603-742-1348
Practice Address - Fax:603-742-9060
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6132207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH81110940Medicaid
NHSANH0940Medicare ID - Type Unspecified
NHC65868Medicare UPIN