Provider Demographics
NPI:1316944937
Name:LAWRIN, OLEH ROMAN (DPM)
Entity type:Individual
Prefix:DR
First Name:OLEH
Middle Name:ROMAN
Last Name:LAWRIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4595 NATHAN W
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-2658
Mailing Address - Country:US
Mailing Address - Phone:586-759-4170
Mailing Address - Fax:586-759-0150
Practice Address - Street 1:4595 NATHAN W
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-2658
Practice Address - Country:US
Practice Address - Phone:586-759-4170
Practice Address - Fax:586-759-0150
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI400101213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1316944937Medicaid
MI0P10660002Medicare PIN
MIT34051Medicare UPIN
MI4855012650OtherBCBS PIN
MI131746414Medicaid