Lawrence, Mallory Andrew
Lawrence, Mallory Andrew is an individual health care provider with primary practice located at 1348 Walton Way Suite 6500, Augusta GA 30901-5104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Lawrence, Mallory Andrew can be contacted via phone (706) 722-2118.Contact Information
Primary practice address
1348 Walton Way Suite 6500
Augusta GA 30901-5104
Phone: (706) 722-2118
Fax: (706) 722-0342
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 026578 | Georgia |
Profile Details
| NPI number | 1790868065 |
|---|---|
| LBN Legal business name | Lawrence, Mallory Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Feb 15th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790868065 | NPPES |
| Georgia | Other | 4140381 | AETNA |
| Georgia | MEDICAID | G26578 | AETNA |
| Georgia | MEDICAID | 00399517A | AETNA |
| Georgia | Other | 1621144003 | AETNA |
| Georgia | Other | 2089751 | AETNA |
| Georgia | Other | 1621144004 | AETNA |
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