Doctor Name: | LAWRENCE ALLEN HANSEN |
NPI Number: | 1699957357 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 4301407500 |
Business Practice Address: | 7445 Allen Rd Suite 190 Allen Park, MI - 481011993 |
Business Phone Number: | 3133822184 |
Business Fax Number: | 3133822189 |
Mailing Address: | 7445 Allen Rd, Suite 190 ALLEN PARK |
State: | MI |
Postal Code: | 481011993 |
Phone Number: | 3133822184 |
Fax Number: | 3133822189 |
NPI Enumeration Date: | 12/04/2007 |
NPI Last Update Date: | 02/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301407500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |