Provider Demographics
NPI:1821104480
Name:LAWRENCE, HENRY STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:STEVEN
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:H.
Other - Middle Name:STEVEN
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1001 LAKESIDE AVE E
Mailing Address - Street 2:#1200
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1260 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1812
Practice Address - Country:US
Practice Address - Phone:216-524-7377
Practice Address - Fax:330-630-4275
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-052066208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0643996Medicaid
LA0706591Medicare ID - Type Unspecified
F11019Medicare UPIN