Provider Demographics
NPI:1427229558
Name:CHRISTYNE LAWSON MD PC
Entity type:Organization
Organization Name:CHRISTYNE LAWSON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:B
Authorized Official - Last Name:VALVONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-353-9460
Mailing Address - Street 1:30400 TELEGRAPH RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4537
Mailing Address - Country:US
Mailing Address - Phone:248-353-9460
Mailing Address - Fax:248-353-8084
Practice Address - Street 1:30400 TELEGRAPH RD
Practice Address - Street 2:SUITE 350
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4537
Practice Address - Country:US
Practice Address - Phone:248-353-9460
Practice Address - Fax:248-353-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICL064439207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0806364881OtherBCBSM
MI3405352Medicaid
MI0806364881OtherBCN
MI0806328422OtherBCBSM
MI080F357340OtherBCBSM
MI0806328422OtherBLUE CARE NETWORK
MIG57780Medicare UPIN
MI3405352Medicaid