Healthcare Provider Details

I. General information

NPI: 1790841096
Provider Name (Legal Business Name): NAJIA C LAWRENCE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 TOWNE LAKE PKWY STE 404
WOODSTOCK GA
30188
US

IV. Provider business mailing address

900 TOWNE LAKE PKWY STE 404
WOODSTOCK GA
30188
US

V. Phone/Fax

Practice location:
  • Phone: 770-926-9229
  • Fax: 678-415-2164
Mailing address:
  • Phone: 770-926-9229
  • Fax: 678-415-2164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number061475
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: