Provider Demographics
NPI:1184696254
Name:LAWTON, WENDY B (MD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:B
Last Name:LAWTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8203 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2434
Mailing Address - Country:US
Mailing Address - Phone:810-953-3690
Mailing Address - Fax:810-953-9543
Practice Address - Street 1:8203 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2434
Practice Address - Country:US
Practice Address - Phone:810-953-3690
Practice Address - Fax:810-953-9543
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301042053208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
C2794OtherMCARE
P85355OtherB CN
3502510661OtherBC BS
350252441OtherHEALTH PLUS
MI4553251Medicaid