Provider Demographics
NPI:1952363749
Name:DEAL, LAWRENCE DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:DAVID
Last Name:DEAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6401 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4341
Mailing Address - Country:US
Mailing Address - Phone:763-572-5710
Mailing Address - Fax:763-571-3008
Practice Address - Street 1:4000 CENTRAL AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-2968
Practice Address - Country:US
Practice Address - Phone:763-572-5710
Practice Address - Fax:763-782-8100
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN38800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN112840OtherUCARE MN
MN772045OtherAMERICA'S PPO
MN5206617OtherAETNA
MN08F14DEOtherBCBS OF MN
MNHP26068OtherHEALTHPARTNERS
MN1016404OtherPREFERRED ONE
MN0102809OtherMEDICA
MN6603825OtherMEDICA UC
MN08F14DEOtherBCBS OF MN