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General NPI Number Information
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NPI Number | 1720475122
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Entity Type | Individual
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Provider Name | SEAN MICHAEL LAWLESS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 700 W 800 N STE 444
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City | OREM
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State | UT
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Zip | 84057-6305
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Country | US
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Telephone | 801-714-6412
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 741729
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City | ATLANTA
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State | GA
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Zip | 30374-1729
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Country | US
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Telephone |
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | S4803
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | S4803
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 12436083-1205
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License Number State | UT
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