MEDICARE: DR. LAWRENCE EIMERS PH.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0921	NC

General Provider Information

NPI Number	:	1245278001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE EIMERS PH.D

Provider Business Mailing Address
First Line	:	400 CRUTCHFIELD STREET
Second Line	:	SUITE E
City	:	DURHAM
State	:	NC
Zip	:	27704
Country	:	US
Telephone Number	:	919-471-6501
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 CRUTCHFIELD ST
Second Line	:	SUITE E
City	:	DURHAM
State	:	NC
Zip	:	27704-2771
Country	:	US
Telephone Number	:	919-471-6501
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	07/08/2007

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