Provider Demographics
NPI:1043311178
Name:LAWRENCE, SCOTT H (DC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:H
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5513 TWIN KNOLLS RD STE 219
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3264
Mailing Address - Country:US
Mailing Address - Phone:410-844-1577
Mailing Address - Fax:410-740-1117
Practice Address - Street 1:5513 TWIN KNOLLS RD STE 219
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3264
Practice Address - Country:US
Practice Address - Phone:410-844-1577
Practice Address - Fax:410-740-1117
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005364-1111N00000X
MD01504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR7860001OtherMARYLAND FEP
MD4394863OtherAETNA
MD2100596OtherMAMSI/OPTIMUM CHOICE/MDIP
MD52136202OtherBLUE SHIELD MARYLAND
MD52136202OtherBLUE SHIELD MARYLAND
MDU11776Medicare UPIN
MD52136202OtherBLUE SHIELD MARYLAND