MEDICARE: DR. DANIEL C. LAWRENCE M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101033289	VA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	080191096	OTHER	VA	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	57537	OTHER	VA	SOUTHERN HEALTH SERVICES
2	4065064	OTHER	VA	AETNA HMO
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	101719	OTHER	VA	ANTHEM BCBS OF VA
6	4065064	OTHER	VA	AETNA LIFE
7	3349759	OTHER	VA	CIGNA
8	232426	OTHER	VA	MAMSI
9	43439	OTHER	VA	SENTARA

NPI Number	:	1992730642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL C. LAWRENCE M.D.

Provider Business Mailing Address
First Line	:	301 CONCOURSE BLVD
Second Line	:	SUITE 210
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-5643
Country	:	US
Telephone Number	:	804-433-1040
Fax Number	:	804-553-3860

Provider Business Practice Location Address
First Line	:	263 MCLAWS CIR
Second Line	:	SUITE 105
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-5674
Country	:	US
Telephone Number	:	757-941-5600
Fax Number	:	757-564-0557

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	09/18/2012

263 MCLAWS CIRCLE , STE 105
WILLIAMSBURG, VA
23185-5674

Practice Phone: 800-759-7291
Practice Fax: 989-667-8745

263 MCLAWS CIR , SUITE 105
WILLIAMSBURG, VA
23185-5674