Healthcare Provider Details

I. General information

NPI: 1578147237
Provider Name (Legal Business Name): IAN MICHAEL LAWRENCE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF COLORADO INTERNAL MEDICINE-PEDIATRICRESID 12631 EAST 17TH AVE, MAILSTOP C316
AURORA CO
80045
US

IV. Provider business mailing address

UNIVERSITY OF COLORADO INTERNAL MEDICINE-PEDIATRICRESID 12631 EAST 17TH AVE, MAILSTOP C316
AURORA CO
80045
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-6595
  • Fax:
Mailing address:
  • Phone: 303-724-6595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA209434
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA209434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: