Provider Demographics
NPI:1780717504
Name:HYMAN, LAWRENCE R (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:R
Last Name:HYMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3681 FOLLY QUARTER RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1452
Mailing Address - Country:US
Mailing Address - Phone:410-997-8847
Mailing Address - Fax:
Practice Address - Street 1:11055 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE # 201
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2896
Practice Address - Country:US
Practice Address - Phone:410-997-8847
Practice Address - Fax:410-997-3809
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD198812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC88767Medicare UPIN
MD796L916DMedicare PIN