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NPI Code Detail

MEDICARE: DR. LAWRENCE H WARBASSE III M.D.

MEDICARE: DR. LAWRENCE H WARBASSE III 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
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician4301047414MI
2207R00000XInternal Medicine Physician4301047414MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2LW047414OTHERMIBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1902801327
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE H WARBASSE III M.D.
Provider Business Mailing Address
First Line : 10850 E TRAVERSE HWY
Second Line : STE. 4400
City : TRAVERSE CITY
State : MI
Zip : 49684-1364
Country : US
Telephone Number : 231-346-6800
Fax Number : 231-346-6052
Provider Business Practice Location Address
First Line : 1105 6TH ST
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2349
Country : US
Telephone Number : 231-346-6800
Fax Number : 231-346-6052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 01/02/2019

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