Provider Demographics
NPI:1982753489
Name:DONLEY, LAWRENCE P (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:P
Last Name:DONLEY
Suffix:
Gender:M
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:PO BOX 4400
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57402-4400
Mailing Address - Country:US
Mailing Address - Phone:605-622-2876
Mailing Address - Fax:605-622-2804
Practice Address - Street 1:305 S STATE ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4527
Practice Address - Country:US
Practice Address - Phone:605-622-5100
Practice Address - Fax:605-622-4030
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079416207P00000X, 207PE0004X
SD10180207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI930120147OtherRAILROAD MEDICARE
MI930120147OtherRAILROAD MEDICARE
MIH65303Medicare UPIN