Provider Demographics
NPI:1801997010
Name:LAWSON, MARVA L (MD)
Entity type:Individual
Prefix:DR
First Name:MARVA
Middle Name:L
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 1:3504 KUMU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1213
Mailing Address - Country:US
Mailing Address - Phone:808-343-6739
Mailing Address - Fax:808-356-0396
Practice Address - Street 1:46-001 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3711
Practice Address - Country:US
Practice Address - Phone:808-343-6739
Practice Address - Fax:808-356-0396
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI148342084P0804X, 2084P0804X
OH350765742084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2675798Medicaid