Healthcare Provider Details

I. General information

NPI: 1275940181
Provider Name (Legal Business Name): BRENDAN LAWSON MD, MMS, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 05/15/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6013 FARRINGTON RD STE 301
CHAPEL HILL NC
27517-8173
US

IV. Provider business mailing address

CAMPUS BOX 7593
CHAPEL HILL NC
27599-7593
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-6669
  • Fax: 984-974-9609
Mailing address:
  • Phone: 919-966-3172
  • Fax: 984-974-9609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: