Provider Demographics
NPI:1982799821
Name:LAWSON, HEALY WEST (MD)
Entity Type:Individual
Prefix:
First Name:HEALY
Middle Name:WEST
Last Name:LAWSON
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 1:3809 COMPUTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6518
Mailing Address - Country:US
Mailing Address - Phone:919-781-9078
Mailing Address - Fax:919-719-0147
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-350-5332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14945OtherWELLPATH
D73366Medicare UPIN
NC2165488Medicare ID - Type Unspecified
NC1406897OtherUNITED HEALTH CARE
NC20186OtherCIGNA
NC80088143OtherRAILROAD MEDICARE
NC8951248Medicaid
NC51248OtherBLUE CROSS BLUE SHIELD