Provider Demographics
NPI:1396736427
Name:LAWRENCE, JENNIFER W (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:W
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:443-481-6469
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PARKWAY
Practice Address - Street 2:ACUTE CARE PAVILLION
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-1000
Practice Address - Fax:443-481-6933
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037151207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
250AAA53492408OtherCAREFIRST
55880005OtherCAREFIRST
108665OtherJOHNS HOPKINS HEALTHCARE
MD529441001Medicaid
55880005OtherCAREFIRST
545P119AMedicare UPIN
108665OtherJOHNS HOPKINS HEALTHCARE
545P119AMedicare UPIN