LAWRENCE L WANG (NPI# 1376568980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376568980 |
| Entity Type | Individual |
| Full Name | LAWRENCE L WANG |
| Credential | M.D., PHD |
| Practice Address |
10004 Kennerly Rd #375-b St. Louis MO 63128-2190 |
| Practice Telephone | 3148425660 |
| Practice Fax Number | 3148420169 |
| Mailing Telephone | 3148425660 |
| Mailing Fax Number | 3148420169 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 2005004447 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538359963 | Lawrence Y Wang | Dentist | 330 E 75th St, Apt#12h, New York, NY 10021-3082 | 2007-08-01 |
| 1548326168 | Lawrence Wang | Optometrist | 7090 N Durango Dr, Ste 110, Las Vegas, NV 89149-4494 | 2006-12-28 |
| 1700994423 | Lawrence C Wang | Psychiatry & Neurology | 3245 International Cir Ste 103, Colorado Springs, CO 80910-3152 | 2006-08-25 |
| 1891713004 | Lawrence Wang | Physical Medicine & Rehabilitation | 18141 Beach Blvd Ste 100, Huntington Beach, CA 92648-1354 | 2006-07-17 |
| 1922004704 | Lawrence P Wang | Internal Medicine | 614 Wooster Pike Ste 7, Terrace Park, OH 45174-1061 | 2005-06-25 |
| 1891273587 | Lawrence Letian Wang | Dentist | 9900 Lincoln Street 2nd Floor, Us Army Dentac, Jblm, WA 98431 | 2018-08-03 |
| 1013440965 | Lawrence Wang | Student in an Organized Health Care Education/Training Program | 100 Madison Ave, Morristown, NJ 07960 | 2017-04-07 |
| 1578954780 | Lawrence Wang | Dentist | 10045 Baltimore National Pike, Suite 1 A, Ellicott City, MD 21042-3673 | 2015-02-10 |
| 1003950494 | Lawrence Pei-wen Wang | Optometrist | 16735 Se 272nd St, Suite C, Covington, WA 98042-4942 | 2007-02-18 |
| 1013086859 | Lawrence C Wang | Radiology | 401 Sw Water St, 1824, Peoria, IL 61602-1571 | 2006-11-07 |
| Street Address |
10004 KENNERLY RD #375-B |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63128-2190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598719478 | Charles W Miller IIi | Dermatology | 10004 Kennerly Rd, #395-b, St. Louis, MO 63128-2190 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1508194309 | John A. Powell Dermatology, Ltd | Dermatology | 1034 So. Brentwood Blvd, Suite 1160, St. Louis, MO 63117-1258 | 2009-12-07 |
| 1295255115 | Jessica Piontek | Dermatology | 615 South New Ballas, St. Louis, MO 63141 | 2017-06-21 |
| 1598719478 | Charles W Miller IIi | Dermatology | 10004 Kennerly Rd, #395-b, St. Louis, MO 63128-2190 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605906 | Deluxe Dermatology LLC | Dermatology | 1034 S Brentwood Blvd Ste 1000, Saint Louis, MO 63117-1210 | 2020-10-03 |
| 1811510886 | Yoon Dermatology LLC | Dermatology | 1060 Meyer Rd, Wentzville, MO 63385-3800 | 2020-05-25 |
| 1417597923 | Anna Marie Aiazzi | Dermatology | 10012 Kennerly Rd Ste 401, Saint Louis, MO 63128-2197 | 2020-01-13 |
| 1790330371 | Baydon Earl Hilton | Dermatology | 1003 Kings Rd, Kirksville, MO 63501-2627 | 2019-08-09 |
| 1528537057 | Cayce Medical Spa, Inc | Dermatology | 2001 Corona Rd Ste 201, Columbia, MO 65203-5924 | 2018-11-14 |
| 1396226981 | Nicole Betty | Dermatology | 413 W Water Street, Greenfield, MO 65661 | 2018-08-22 |
| 1366946832 | Novahealth Medical Group, LLC | Dermatology | 3208 Lemone Industrial Blvd Ste A, Columbia, MO 65201-8244 | 2018-03-20 |
| 1952757007 | Stacy Gittel Blum | Dermatology | 222 S Woods Mill Rd Ste 480, Chesterfield, MO 63017-3625 | 2016-05-08 |
| 1508248576 | Kaitlin Ann Schiavo | Dermatology | 204 N Keene St Ste 100, Columbia, MO 65201-8136 | 2015-06-25 |
| 1821482373 | David Cotter | Dermatology | 9450 Minerva Ave, Saint Louis, MO 63114-3910 | 2015-03-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.