MEDICARE: DAVID E LAW MD

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	207RP1001X	Pulmonary Disease Physician	ME0039816	FL
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	ME39816	FL

General Provider Information

NPI Number	:	1952398943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID E LAW MD

Provider Business Mailing Address
First Line	:	5517 21ST AVE W
Second Line	:	STE F
City	:	BRADENTON
State	:	FL
Zip	:	34209-5604
Country	:	US
Telephone Number	:	941-792-8383
Fax Number	:	941-792-8484

Provider Business Practice Location Address
First Line	:	5517 21ST AVE W
Second Line	:	STE F
City	:	BRADENTON
State	:	FL
Zip	:	34209-5604
Country	:	US
Telephone Number	:	941-792-8383
Fax Number	:	941-792-8484

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	11/26/2012

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