Healthcare Provider Details

I. General information

NPI: 1528048832
Provider Name (Legal Business Name): LAWRENCE YAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 WESTERN MARYLAND PKWY SUITE 101
HAGERSTOWN MD
21740-5146
US

IV. Provider business mailing address

4801 FAIRMONT AVE APT 901
BETHESDA MD
20814-6046
US

V. Phone/Fax

Practice location:
  • Phone: 301-733-1477
  • Fax: 301-733-7758
Mailing address:
  • Phone: 703-287-4189
  • Fax: 703-448-1807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0055875
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG68220
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC10005912
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD30704
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD12698
License Number StateHI
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35077798Y
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD071072L
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberL2063
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101226328
License Number StateVA
# 10
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number44741
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: