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General NPI Number Information
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NPI Number | 1780842336
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Entity Type | Organization
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Legal Business Name | LAWRENCE L .STOCKER MD PC
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 6010 W MAPLE RD #200
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-4406
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Country | US
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Telephone | 248-737-6955
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Fax | 248-737-8759
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Provider Business Mailing Address
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Address Line | 6010 W MAPLE RD #200
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-4406
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Country | US
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Telephone | 248-737-6955
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Fax | 248-737-8759
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Authorized Official
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Title or Position | PRESEDENT
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Name | DR. LAWRENCE STOCKER
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Credential | MD
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Telephone | 248-737-6955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301015492
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License Number State | MI
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