MEDICARE: ROBERT D LAWRENCE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A22667	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033187158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT D LAWRENCE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 77800
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95267-1100
Country	:	US
Telephone Number	:	209-477-4432
Fax Number	:	209-320-6136

Provider Business Practice Location Address
First Line	:	2291 W MARCH LN
Second Line	:	SUITE 179E
City	:	STOCKTON
State	:	CA
Zip	:	95207-6652
Country	:	US
Telephone Number	:	209-477-4432
Fax Number	:	209-320-6136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/09/2007

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