Provider Demographics
NPI:1437149382
Name:LAUER, MARK STEVEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:STEVEN
Last Name:LAUER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4 PEBBLE ACRES CT
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049-1665
Mailing Address - Country:US
Mailing Address - Phone:636-677-0448
Mailing Address - Fax:314-251-5873
Practice Address - Street 1:12120 CONWAY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8213
Practice Address - Country:US
Practice Address - Phone:314-251-7843
Practice Address - Fax:314-251-5873
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO040178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist