Provider Demographics
NPI:1861581787
Name:FELDMAN, LAWRENCE R (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:R
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GARRISON FOREST RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4106
Mailing Address - Country:US
Mailing Address - Phone:410-581-3728
Mailing Address - Fax:
Practice Address - Street 1:902 WASHINGTON RD
Practice Address - Street 2:SUITE E
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5827
Practice Address - Country:US
Practice Address - Phone:410-876-0286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD32185207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD151145ZDK7Medicare PIN
MD151145YEZXMedicare PIN