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NPI Code Detail

MEDICARE: DR. LAWRENCE G. FOE MD

MEDICARE: DR. LAWRENCE G. FOE 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
1207Q00000XFamily Medicine Physician4301051179MI

General Provider Information

NPI Number : 1689678401
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE G. FOE MD
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7128 FULTON ST E
Second Line :
City : ADA
State : MI
Zip : 49301-8413
Country : US
Telephone Number : 616-825-3530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 12/13/2024

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Directions to “ DR. LAWRENCE G. FOE MD” Practice Location

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