Provider Demographics
NPI:1447358874
Name:MCAULIFFE, LAWRENCE STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:STEPHEN
Last Name:MCAULIFFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:25 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3129
Mailing Address - Country:US
Mailing Address - Phone:508-778-1829
Mailing Address - Fax:508-778-0113
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3129
Practice Address - Country:US
Practice Address - Phone:508-778-1829
Practice Address - Fax:508-778-0113
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA47818207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2272937OtherAETNA
MA25-00638OtherUNITED HEALTHCARE
MA060058506OtherMEDICARE ID
MA1447358874OtherNETWORK HEALTH
MA3223OtherHARVARD PILGRIM
MA712757OtherTUFTS
11086042OtherCAQH
MA000000030690OtherBOSTON MEDICAL CENTER
MA1447358874OtherUNICARE
MA1447358874OtherGREAT WEST HEALTHCARE
MA0168637Medicaid
MA6796921-001OtherCIGNA
MAL15142OtherBLUE CROSS BLUE SHIELD
MAS017060OtherTRICARE
A66693Medicare UPIN
11086042OtherCAQH