Provider Demographics
NPI:1942263801
Name:LAWRENCE, MARIA L (DO)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-790-3697
Mailing Address - Fax:989-790-5035
Practice Address - Street 1:2429 TRAUTNER DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9596
Practice Address - Country:US
Practice Address - Phone:989-790-3697
Practice Address - Fax:989-790-5035
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2017-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101011657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0985177OtherHEALTH PLUS
MIG35451OtherHEALTH NET FEDERAL SERVIC
MI700Z946010OtherBLUE CROSS BLUE SHIELD
MI700Z946010OtherCOMMUNITY BLUE
MI1009401OtherMCLAREN HEALTH PLAN
MI4563196Medicaid
MI700Z946010OtherBLUE CARE NETWORK
MI0857900154OtherBLUE CROSS BLUE SHIELD
MI0985177OtherBAY PHYSICIANS HEALTH PLA
MI1009401OtherHEALTH ADVANTAGE
MI700Z946010OtherBLUE CHOICE
MI700Z946010OtherBLUE CHOICE
MI0985177OtherHEALTH PLUS