Healthcare Provider Details

I. General information

NPI: 1841828043
Provider Name (Legal Business Name): LAWRENCE GUAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 BROWNING PL
RALEIGH NC
27609-6504
US

IV. Provider business mailing address

3949 BROWNING PL
RALEIGH NC
27609-6504
US

V. Phone/Fax

Practice location:
  • Phone: 919-787-7411
  • Fax:
Mailing address:
  • Phone: 919-787-7411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number2026-01004
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: