Provider Demographics
NPI:1942370366
Name:SHEDWICK, LAWRENCE ANDREW JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:ANDREW
Last Name:SHEDWICK
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:100 STERRETT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-3234
Mailing Address - Country:US
Mailing Address - Phone:412-922-3472
Mailing Address - Fax:724-657-6714
Practice Address - Street 1:2602 WILMINGTON RD
Practice Address - Street 2:SUITE 204
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1537
Practice Address - Country:US
Practice Address - Phone:724-657-5285
Practice Address - Fax:724-657-6714
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMA003429L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA055400Medicare ID - Type Unspecified