Healthcare Provider Details

I. General information

NPI: 1851602684
Provider Name (Legal Business Name): CHRISTOPHER LAWRANCE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2010
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S EUCLID AVE BOX 8109
SAINT LOUIS MO
63110-1010
US

IV. Provider business mailing address

660 S EUCLID AVE BOX 8109
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-8028
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2010017828
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number2012022302
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: