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1578778585
LAWRENCE VIDAVER
GLEN BURNIE, MD
NPI
1578778585
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MD 025559)
Enumeration Date
2007-05-12
Last Update Date
2024-05-17
Business Address
Dr. LAWRENCE VIDAVER MD
1414 CRAIN HWY N STE 6A
GLEN BURNIE, MD 21061-7001
Phone number: 410-761-1031
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Mailing Address
Dr. LAWRENCE VIDAVER MD
1414 CRAIN HWY N STE 6A
GLEN BURNIE, MD 21061-7001
Phone number: 410-848-8202
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