Provider Demographics
NPI:1891729976
Name:LAWRENCE, DAVID MICHAEL (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BEACH STREET
Mailing Address - Street 2:BLDG C
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891
Mailing Address - Country:US
Mailing Address - Phone:401-596-0823
Mailing Address - Fax:401-596-2960
Practice Address - Street 1:85 BEACH STREET
Practice Address - Street 2:BLDG C
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891
Practice Address - Country:US
Practice Address - Phone:401-596-0823
Practice Address - Fax:401-596-2960
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDPM00225213E00000X
CT000428213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT030000428CT01OtherANTHEM OF CT
RI030881OtherHEALTH NET
CT030881OtherHEALTHNET
RI2700176OtherUNITED HEALTHCARE
RI480033446OtherMETRAHEALTH
CT480033446OtherMETRAHEALTH
CT708699OtherCONNECTICARE
CT030881OtherHEALTH NET
CJ6759OtherRR MEDICARE GROUP PROVIDER NUMBER
RI030000225RI01OtherANTHEM
050448699OtherUNITED HEALTHCARE OTHER
RI201484OtherBLUE CHIP
RI050448699OtherTRICARE
CT050448699OtherTRICARE
1467574475OtherGROUP NPI FOR DAVID LAWRENCE
RI480033446OtherRR MEDICARE
RI708699OtherCONNECTICARE
RIP795857OtherOXFORD
RI489007028OtherBLUE CROSS OF RI
RIP795857OtherOXFORD
CT030881OtherHEALTHNET
T22357Medicare UPIN