Provider Demographics
NPI:1457508319
Name:WINTER, LAURENCE EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:EDWARD
Last Name:WINTER
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 1:8100 SCHENDEL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LORETTO
Mailing Address - State:MN
Mailing Address - Zip Code:55357-9590
Mailing Address - Country:US
Mailing Address - Phone:763-498-7781
Mailing Address - Fax:
Practice Address - Street 1:8100 SCHENDEL LAKE DR
Practice Address - Street 2:
Practice Address - City:LORETTO
Practice Address - State:MN
Practice Address - Zip Code:55357-9590
Practice Address - Country:US
Practice Address - Phone:763-498-7781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN18475207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck