Provider Demographics
NPI:1871681189
Name:ADLER, LAWRENCE WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:WARREN
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1307 CRAIN HWY S
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4024
Mailing Address - Country:US
Mailing Address - Phone:410-761-7042
Mailing Address - Fax:410-761-7984
Practice Address - Street 1:7310 RITCHIE HIGHWAY
Practice Address - Street 2:#512
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061
Practice Address - Country:US
Practice Address - Phone:410-761-7042
Practice Address - Fax:410-761-7984
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD194542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD404484300Medicaid
MD401381600Medicaid
MD401381600Medicaid
MD559LMedicare ID - Type Unspecified
MD404484300Medicaid