Provider Demographics
NPI:1912971037
Name:GARBER, LAWRENCE D (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:D
Last Name:GARBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5 NEPONSET ST
Mailing Address - Street 2:WOT 2ND FL, STE C203
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-595-2300
Mailing Address - Fax:508-853-5226
Practice Address - Street 1:5 NEPONSET ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2714
Practice Address - Country:US
Practice Address - Phone:508-595-2300
Practice Address - Fax:508-853-5226
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA54027207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110175048OtherRAILROAD MEDICARE
26821OtherHEALTHY START
AA1294OtherHARVARD PILGRIM HEALTHCAR
7397321OtherAETNA US HEALTHCARE
J04890OtherBLUE SHIELD HMO BLUE
0401726OtherEVERCARE
26821OtherCHILDRENS MEDICAL SECURIT
1192803OtherCIGNA HEALTH PLAN
J04890OtherBLUE CARE ELECT
042472266OtherHEALTHCARE VALUE MANAGEME
1060236OtherFIRST HEALTH
042472266OtherPRIVATE HEALTHCARE SYSTEM
9900097OtherFALLON COMMUNITY HEALTH P
042472266OtherONE HEALTH PLAN
6195288OtherMEDICAID WELFARE
MA6195288Medicaid
784136OtherMVP HEALTH CARE
A58093Medicare UPIN
1060236OtherFIRST HEALTH
784136OtherMVP HEALTH CARE