Healthcare Provider Details

I. General information

NPI: 1114120862
Provider Name (Legal Business Name): ERIKA LAWRENCE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 E SOUTHERN AVE STE 1
TEMPE AZ
85282
US

IV. Provider business mailing address

PO BOX 41150
MESA AZ
85274
US

V. Phone/Fax

Practice location:
  • Phone: 480-425-2160
  • Fax: 480-351-8797
Mailing address:
  • Phone: 480-425-2160
  • Fax: 480-351-8797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number44785
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: