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General NPI Number Information
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NPI Number | 1841327178
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Entity Type | Individual
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Provider Name | LAWRENCE STEPHEN BROWN DPM
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 25511 VAN DYKE AVE STE 100
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City | CENTER LINE
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State | MI
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Zip | 48015-1834
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Country | US
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Telephone | 586-758-5770
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Fax | 586-758-6134
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Provider Business Mailing Address
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Address Line | 25511 VAN DYKE AVE STE 100
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City | CENTER LINE
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State | MI
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Zip | 48015-1834
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Country | US
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Telephone | 586-758-5770
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | LB001169
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License Number State | MI
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