Provider Demographics
NPI:1538242698
Name:LAWRENCE S. HURWITZ, M.D.
Entity type:Organization
Organization Name:LAWRENCE S. HURWITZ, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:SHELDON
Authorized Official - Last Name:HURWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-273-7784
Mailing Address - Street 1:2266 N PROSPECT AVE
Mailing Address - Street 2:SUITE #503
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-6319
Mailing Address - Country:US
Mailing Address - Phone:414-273-7784
Mailing Address - Fax:414-273-4837
Practice Address - Street 1:2266 N PROSPECT AVE
Practice Address - Street 2:SUITE #503
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-6319
Practice Address - Country:US
Practice Address - Phone:414-273-7784
Practice Address - Fax:414-273-4837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18385314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30913600Medicaid
WI1538242698OtherNATIONAL PROVIDER NUMBER
WI30913600Medicaid
WI1538242698OtherNATIONAL PROVIDER NUMBER