MEDICARE: DR. DOROTHY E. LAWSE M.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	207P00000X	Emergency Medicine Physician	22891	IA
2	207P00000X	Emergency Medicine Physician	48947	MN
3	207P00000X	Emergency Medicine Physician	13277	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	930038886	OTHER	IA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	51871	OTHER	IA	WELLMARK BC/BS IOWA

General Provider Information

NPI Number	:	1508844457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOROTHY E. LAWSE M.D.

Provider Business Mailing Address
First Line	:	1825 LOGAN AVE
Second Line	:	EMERGENCY DEPARTMENT
City	:	WATERLOO
State	:	IA
Zip	:	50703-1916
Country	:	US
Telephone Number	:	319-235-3697
Fax Number	:	319-235-3844

Provider Business Practice Location Address
First Line	:	1825 LOGAN AVE
Second Line	:	EMERGENCY DEPARTMENT
City	:	WATERLOO
State	:	IA
Zip	:	50703-1916
Country	:	US
Telephone Number	:	319-235-3697
Fax Number	:	319-235-3844

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

Provider Enumeration Date	:	01/02/2006
Last Update Date	:	08/27/2008

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