MEDICARE: DR. LAWRENCE A BUCKLEW MW

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	174400000X	Specialist	MD020506E	PA

General Provider Information

NPI Number	:	1265404297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE A BUCKLEW MW

Provider Business Mailing Address
First Line	:	200 DELAFIELD RD
Second Line	:	SUITE 3010
City	:	PITTSBURGH
State	:	PA
Zip	:	15215-3205
Country	:	US
Telephone Number	:	412-781-4860
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 DELAFIELD RD
Second Line	:	SUITE 3010
City	:	PITTSBURGH
State	:	PA
Zip	:	15215-3205
Country	:	US
Telephone Number	:	412-781-4860
Fax Number	:

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	07/08/2007

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