Provider Demographics
NPI:1699004309
Name:M. DAVID LAUTER, MD, PC
Entity Type:Organization
Organization Name:M. DAVID LAUTER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOC
Authorized Official - Prefix:DR
Authorized Official - First Name:M DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUTR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-433-7500
Mailing Address - Street 1:200 GRIFFIN RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7145
Mailing Address - Country:US
Mailing Address - Phone:603-433-7500
Mailing Address - Fax:
Practice Address - Street 1:200 GRIFFIN RD
Practice Address - Street 2:SUITE 11
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7145
Practice Address - Country:US
Practice Address - Phone:603-433-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty