Provider Demographics
NPI:1154346823
Name:ASHKER, LAWRENCE J (DO)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:J
Last Name:ASHKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 N WESTHAVEN DR
Mailing Address - Street 2:AURORA MEDICAL GROUP
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-7668
Mailing Address - Country:US
Mailing Address - Phone:248-990-7095
Mailing Address - Fax:
Practice Address - Street 1:1101 W UNIVERSITY DR
Practice Address - Street 2:RADIOLOGY DEPT
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1863
Practice Address - Country:US
Practice Address - Phone:248-652-5325
Practice Address - Fax:248-652-9731
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0103642085R0202X
WI50855-0212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4772973Medicaid
F36447017Medicare ID - Type Unspecified
MI4772973Medicaid