Healthcare Provider Details

I. General information

NPI: 1255442174
Provider Name (Legal Business Name): LAWRENCE B COLEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6261 E VIRGINIA BEACH BLVD SUITE 100
NORFOLK VA
23502-2964
US

IV. Provider business mailing address

6261 E VIRGINIA BEACH BLVD SUITE 100
NORFOLK VA
23502-2964
US

V. Phone/Fax

Practice location:
  • Phone: 757-466-1000
  • Fax: 757-466-7788
Mailing address:
  • Phone: 757-466-1000
  • Fax: 757-466-7788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number0101044977
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: