=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063410454
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAWRENCE D SINGER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2005
-----------------------------------------------------
Last Update Date | 12/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 63 OFFICE PARK DR
-----------------------------------------------------
City | ROANOKE RAPIDS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27870-4940
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-535-4343
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 705 STONEYBROOK DR
-----------------------------------------------------
City | ROANOKE RAPIDS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27870-3167
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-537-5394
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 200500731
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 200500731
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------