Provider Demographics
NPI:1326166364
Name:COLESON-SCHREUR, LAURA (LAC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:COLESON-SCHREUR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3709
Mailing Address - Country:US
Mailing Address - Phone:410-464-0900
Mailing Address - Fax:410-464-0600
Practice Address - Street 1:5801 FALLS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3709
Practice Address - Country:US
Practice Address - Phone:410-464-0900
Practice Address - Fax:410-464-0600
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00688171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD002082311OtherUNITED HEALTH CARE