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General NPI Number Information
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NPI Number | 1063449932
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Entity Type | Individual
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Provider Name | LAWRENCE RICHARD CHARNAS M.D., PHD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | UNIVERSITY OF MINNESOTA PHYSICIANS 516 DELAWARE STREET SE
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-672-7122
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Fax |
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Provider Business Mailing Address
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Address Line | UNIVERSITY OF MINNESOTA PHYSICIANS 420 DELAWARE STREET SE, MMC 295
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-625-7466
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Fax | 612-624-7681
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | 41594
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207SG0202X
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Taxonomy Name | Clinical Biochemical Genetics Physician
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License Number | 41594
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207SG0203X
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Taxonomy Name | Clinical Molecular Genetics Physician
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License Number | 41594
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 41594
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 41594
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License Number State | MN
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