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General NPI Number Information
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NPI Number | 1093726101
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Entity Type | Individual
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Provider Name | MATTHEW W LAWRENCE DO
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 649 SHORE RD
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2449
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Country | US
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Telephone | 609-365-6200
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Fax | 609-926-4311
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Provider Business Mailing Address
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Address Line | 1 E. NEW YORK AVE 4TH FLOOR -SPG
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City | SOMERS POINT
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State | NJ
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Zip | 08244
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Country | US
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Telephone | 609-653-3994
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Fax | 609-926-4311
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C20007648
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | OS010450L
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License Number State | PA
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