Healthcare Provider Details

I. General information

NPI: 1588646343
Provider Name (Legal Business Name): LAWRENCE F HANDLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19176 HALL RD STE 110
CLINTON TWP MI
48038-6914
US

IV. Provider business mailing address

19176 HALL RD STE 110
CLINTON TWP MI
48038-6914
US

V. Phone/Fax

Practice location:
  • Phone: 586-286-3400
  • Fax: 586-286-3619
Mailing address:
  • Phone: 586-286-3400
  • Fax: 586-286-3619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number4301047966
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4301047966
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: