LAWRENCE VIDAVER MD

GLEN BURNIE, MD
NPI1336354356
Entity TypeOrganization
Authorized ContactLOUISE MACY
Billing Mgr
410-298-8223
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: MD  025559)
Enumeration Date2007-05-12
Last Update Date2007-11-20
Business Address
LAWRENCE VIDAVER MD
1411 MADISON PARK DR
GLEN BURNIE, MD 21061-5613
Phone number: 410-761-1037
Mailing Address
LAWRENCE VIDAVER MD
2506 LARRYVALE RD
BALTIMORE, MD 21209-3206
Phone number: 410-764-1116
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