Provider Demographics
NPI:1821221623
Name:HALL, LAWRENCE DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:DAVID
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14275 MIDWAY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3614
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:3805 W CHESTER PIKE
Practice Address - Street 2:BLDG D, SUITE 120
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-2329
Practice Address - Country:US
Practice Address - Phone:800-257-0117
Practice Address - Fax:610-550-3079
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2015-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYMD451346207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology