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General NPI Number Information
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NPI Number | 1336397538
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Entity Type | Individual
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Provider Name | ANDRIJ IHOR LAWRIN PA
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Gender | Male
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 1105 SIXTH ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2345
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Country | US
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Telephone | 231-922-9270
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Fax | 231-922-9271
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Provider Business Mailing Address
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Address Line | PO BOX 27127
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City | LANSING
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State | MI
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Zip | 48909-7127
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Country | US
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Telephone | 231-922-9270
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Fax | 231-922-9271
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601005327
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License Number State | MI
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