Provider Demographics
NPI:1184696288
Name:HARMS, LAWRENCE L (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:L
Last Name:HARMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:MAILSTOP 21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1309
Mailing Address - Country:US
Mailing Address - Phone:952-883-7961
Mailing Address - Fax:952-883-5395
Practice Address - Street 1:6845 LEE AVE N
Practice Address - Street 2:MAIL STOP 31400A
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-1717
Practice Address - Country:US
Practice Address - Phone:763-569-0300
Practice Address - Fax:763-569-0311
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR3H94207V00000X
MN44331207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN470683800Medicaid
MN160002010Medicare ID - Type Unspecified
MN470683800Medicaid