Provider Demographics
NPI:1134288053
Name:LAUER, MARK ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:LAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:111 JOSHUA COURT
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036
Mailing Address - Country:US
Mailing Address - Phone:717-583-0495
Mailing Address - Fax:
Practice Address - Street 1:8170 ADAMS DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036
Practice Address - Country:US
Practice Address - Phone:717-566-8400
Practice Address - Fax:717-566-4893
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-056348-L2083X0100X, 208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG19005Medicare UPIN