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:
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Health care specialties

SpecialtyCodeLicense #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 16 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.

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Identifiers

StateTypeNumberIssuer
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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