Provider Demographics
NPI:1043278930
Name:WINIKUR, LAWRENCE J (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:WINIKUR
Suffix:
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 1:10384 MARTINSVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-6885
Mailing Address - Country:US
Mailing Address - Phone:434-685-7855
Mailing Address - Fax:434-685-7929
Practice Address - Street 1:10384 MARTINSVILLE HWY
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-6885
Practice Address - Country:US
Practice Address - Phone:434-685-7855
Practice Address - Fax:434-685-7929
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059090208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007000057Medicaid
VA384993OtherBC/BS (ANTHEM)
VA384993OtherBC/BS (ANTHEM)
VAE90631Medicare UPIN