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
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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