LAWRENCE VIDAVER MD
NPI 1336354356
Internal Medicine in Glen Burnie, MD

Active since May 12, 2007
1411 MADISON PARK DR, GLEN BURNIE, MD 21061(410) 761-1037(410) 298-8225 Get Directions Write a Review

NPPES record last updated: November 20, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lawrence Vidaver Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAWRENCE VIDAVER MD (NPI 1336354356) is a healthcare organization registered as an internal medicine in Glen Burnie, Maryland and active in the NPI registry since May 2007. The organization lists Louise Macy, Billing Mgr, as its authorized official.

NPPES Registry Identity

NPI1336354356
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLAWRENCE VIDAVER MD
Location Address1411 MADISON PARK DRGlen Burnie, MD 21061-5613
Mailing Address2506 Larryvale RdBaltimore, MD 21209-3206 · (410) 764-1116 · Fax (410) 298-8225
Fax(410) 298-8225
Organization SubpartNo
Authorized OfficialLouise MacyBilling Mgr · (410) 298-8223
Enumeration DateMay 12, 2007
Last NPPES UpdateNovember 20, 2007
NPI 1336354356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in MD · 025559
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1411 MADISON PARK DR, Glen Burnie, MD 21061

Other Identifiers 2

Medicare UPINB69824MD
Medicare PIN8634MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
1411 MADISON PARK DR, SUITE 1A
GLEN BURNIE, MD 21061
Internal Medicine
1411 MADISON PARK DR, SUITE 1B
GLEN BURNIE, MD 21061
Internal Medicine
1411 MADISON PARK DR, SUITE 1B
GLEN BURNIE, MD 21061
Internal Medicine
1411 MADISON PARK DR, SUITE 2B
GLEN BURNIE, MD 21061
Chiropractor
1411 MADISON PARK DR, SUITE 1A
GLEN BURNIE, MD 21061
Nurse Practitioner (Gerontology)
1411 MADISON PARK DR, SUITE 2B
GLEN BURNIE, MD 21061
Clinic/Center (Health Service)
1411 MADISON PARK DR
GLEN BURNIE, MD 21061
Chiropractor
1411 MADISON PARK DR, SUITE 1A
GLEN BURNIE, MD 21061

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lawrence Vidaver MD's NPI number?

The NPI number for Lawrence Vidaver MD is 1336354356. It was assigned to this organization in the NPPES registry on May 12, 2007.

Where is Lawrence Vidaver MD located?

Lawrence Vidaver MD is located at 1411 Madison Park Dr, Glen Burnie, MD 21061. The listed phone number is (410) 761-1037.

What is Lawrence Vidaver MD's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Lawrence Vidaver MD was last updated on November 20, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.