MEDICARE: DR. DUANE MATTHEW LAWRENCE 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	2084P0800X	Psychiatry Physician	0101238548	VA

General Provider Information

NPI Number	:	1497718845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUANE MATTHEW LAWRENCE MD

Provider Business Mailing Address
First Line	:	1083 INDEPENDENCE BLVD STE 187
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-5523
Country	:	US
Telephone Number	:	757-910-2270
Fax Number	:

Provider Business Practice Location Address
First Line	:	328 OFFICE SQUARE LN STE 104
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3648
Country	:	US
Telephone Number	:	757-910-2270
Fax Number	:

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	08/29/2022

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