Provider Demographics
NPI:1689856221
Name:LAWSON, TERRENCE TREMAYNE
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:TREMAYNE
Last Name:LAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3395 STURTEVANT ST SUITE 1
Mailing Address - Street 2:NMC SD MERCY DET
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92136-5075
Mailing Address - Country:US
Mailing Address - Phone:803-410-0586
Mailing Address - Fax:
Practice Address - Street 1:NMC SD MERCY DET
Practice Address - Street 2:3395 STURTEVANT ST SUITE 1
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92136-5075
Practice Address - Country:US
Practice Address - Phone:803-410-0586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman