Provider Demographics
NPI:1720008576
Name:BLOB, LAWRENCE F (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:F
Last Name:BLOB
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 1:3131 CONNECTICUT AVE NW
Mailing Address - Street 2:QA APT. # 2313
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5000
Mailing Address - Country:US
Mailing Address - Phone:410-262-1908
Mailing Address - Fax:
Practice Address - Street 1:3131 CONNECTICUT AVE NW
Practice Address - Street 2:QA APT. # 2313
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5000
Practice Address - Country:US
Practice Address - Phone:410-262-1908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0021589207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine