Provider Demographics
NPI:1124133947
Name:LAWSON, NOEL S (MD)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:S
Last Name:LAWSON
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 1:22101 MOROSS RD
Mailing Address - Street 2:SJHMC - DEPARTMENT OF PATHOLOGY
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-343-3520
Mailing Address - Fax:313-881-4727
Practice Address - Street 1:22101 MOROSS RD
Practice Address - Street 2:SJHMC - DEPARTMENT OF PATHOLOGY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-343-3520
Practice Address - Fax:313-881-4727
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301025988207ZP0102X, 207ZP0104X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Not Answered207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B48894Medicare UPIN
M94320001Medicare ID - Type Unspecified