Lawrence Vidaver MD
NPI #1336354356 in Glen Burnie, Maryland
Provider Information
- NPI Number
- 1336354356
- Entity Type
- Organization
- Organization Name
- Lawrence Vidaver MD
- Primary Specialty
- Internal Medicine
- Enumeration Date
- May 12, 2007
- Last Updated
- Nov 20, 2007
Practice Location
- Address
- 1411 MADISON PARK DR
- City
- Glen Burnie
- State
- Maryland
- ZIP Code
- 21061-5613
- Phone
- (410) 761-1037
Authorized Official
- Name
- LOUISE MACY
- Title
- BILLING MGR
- Phone
- (410) 298-8223
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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