Provider Demographics
NPI:1699867184
Name:HERSCH, LAWRENCE B (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:B
Last Name:HERSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4789 BRIAR RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3902
Mailing Address - Country:US
Mailing Address - Phone:303-637-1739
Mailing Address - Fax:303-530-7856
Practice Address - Street 1:4789 BRIAR RIDGE TRL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3902
Practice Address - Country:US
Practice Address - Phone:303-637-1739
Practice Address - Fax:303-530-7856
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2008-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO172772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry