MEDICARE: DR. LAWRENCE I PASIK 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	207K00000X	Allergy & Immunology Physician	4301030633	MI

General Provider Information

NPI Number	:	1922071562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE I PASIK M.D.

Provider Business Mailing Address
First Line	:	5775 WEST MAPLE ROAD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322
Country	:	US
Telephone Number	:	248-626-5315
Fax Number	:	248-626-2248

Provider Business Practice Location Address
First Line	:	5775 WEST MAPLE ROAD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322
Country	:	US
Telephone Number	:	248-626-5315
Fax Number	:	248-626-2248

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	01/24/2023

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