Provider Demographics
NPI:1457377632
Name:LAWSON, ELLEN TUCH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:TUCH
Last Name:LAWSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 APPLECROSS RD
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 PATTON AVE.
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2707
Practice Address - Country:US
Practice Address - Phone:828-252-4878
Practice Address - Fax:828-252-4103
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34377207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8951249Medicaid
NC8901414Medicaid
NC890275EMedicaid
NC7902767Medicaid
NC2163884CMedicare ID - Type Unspecified
NCE01235Medicare UPIN
NC2314189Medicare ID - Type Unspecified
NC8901414Medicaid
NC8951249Medicaid
NC1047Medicare ID - Type Unspecified
NC2163884DMedicare ID - Type Unspecified