Provider Demographics
NPI:1407890536
Name:LAUER, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:LAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W WACKERLY ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2761
Mailing Address - Country:US
Mailing Address - Phone:989-832-0900
Mailing Address - Fax:989-633-0349
Practice Address - Street 1:301 W WACKERLY ST
Practice Address - Street 2:SUITE B
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2761
Practice Address - Country:US
Practice Address - Phone:989-832-0900
Practice Address - Fax:989-633-0349
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075408207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301075408OtherSTATE LICENSE
MIH08434Medicare UPIN