Provider Demographics
NPI:1891724548
Name:SWINK, LAWRENCE R (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:R
Last Name:SWINK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5450 KNOLL NORTH DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2300
Mailing Address - Country:US
Mailing Address - Phone:410-964-6200
Mailing Address - Fax:410-964-6392
Practice Address - Street 1:5450 KNOLL NORTH DR
Practice Address - Street 2:SUITE 250
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2300
Practice Address - Country:US
Practice Address - Phone:410-964-6200
Practice Address - Fax:410-964-6392
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0017135207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00228696OtherMEDICARE RAILROAD
MDP00228696OtherMEDICARE RAILROAD
E16561Medicare UPIN