MEDICARE: DR. LAWRENCE C SWEET MD

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	207K00000X	Allergy & Immunology Physician	4301022261	MI

General Provider Information

NPI Number	:	1255321287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE C SWEET MD

Provider Business Mailing Address
First Line	:	18161 W 13 MILE RD
Second Line	:	SUITE C
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-1113
Country	:	US
Telephone Number	:	248-646-3131
Fax Number	:	248-646-5871

Provider Business Practice Location Address
First Line	:	18161 W 13 MILE RD
Second Line	:	SUITE C
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-1113
Country	:	US
Telephone Number	:	248-646-3131
Fax Number	:	248-646-5871

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	02/03/2011

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