Shinneman, Lawrence A
Shinneman, Lawrence A is an individual health care provider with primary practice located at 4121 S. Michigan Street , South Bend IN 46614-2545. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Shinneman, Lawrence A can be contacted via phone (574) 291-9200.Contact Information
Primary practice address
4121 S. Michigan Street
South Bend IN 46614-2545
Phone: (574) 291-9200
Fax: (574) 299-4423
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18002288 | Indiana |
Profile Details
| NPI number | 1306813464 |
|---|---|
| LBN Legal business name | Shinneman, Lawrence A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2006 |
| Last updated | Apr 3rd, 2012 - 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 | 1306813464 | NPPES |
| Indiana | MEDICAID | 200305600 |
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