Provider Demographics
NPI:1699770255
Name:LAWRENCE, MARVIN E II (MD)
Entity type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:E
Last Name:LAWRENCE
Suffix:II
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 1:12510 PROSPERITY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1663
Mailing Address - Country:US
Mailing Address - Phone:240-485-5200
Mailing Address - Fax:301-625-6906
Practice Address - Street 1:7350 VAN DUSEN RD
Practice Address - Street 2:STE 210
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5268
Practice Address - Country:US
Practice Address - Phone:301-498-5500
Practice Address - Fax:301-498-7346
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058872207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD616770-01OtherCAREFIRST BSMD
DCA1110002OtherCAREFIRST BCBS DC
MDN5630033OtherCAREFIRST MD/DC
MD100016445OtherRAILROAD MEDICARE
DCA1130003OtherCAREFIRST BCBS DC
DC2516-0006OtherCAREFIRST BSDC
MDP00679062OtherRAILROAD MEDICARE
MD510101800Medicaid
MD510101800Medicaid
DCA1130003OtherCAREFIRST BCBS DC
MDH63475Medicare UPIN
MD100016445OtherRAILROAD MEDICARE