Provider Demographics
NPI:1922363365
Name:LAWANSON, DUNSTAN O
Entity Type:Individual
Prefix:
First Name:DUNSTAN
Middle Name:O
Last Name:LAWANSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3588 POWDER MILL RD,
Mailing Address - Street 2:# 104
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705
Mailing Address - Country:US
Mailing Address - Phone:202-549-2729
Mailing Address - Fax:
Practice Address - Street 1:3588 POWDER MILL RD,
Practice Address - Street 2:# 104
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705
Practice Address - Country:US
Practice Address - Phone:202-549-2729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide