Provider Demographics
NPI:1710041546
Name:LAUER, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
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 1:104 LOUISIANA AVE
Mailing Address - Street 2:RMC FERRIDAY CLINIC
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-2826
Mailing Address - Country:US
Mailing Address - Phone:318-757-0210
Mailing Address - Fax:318-757-0244
Practice Address - Street 1:104 LOUISIANA AVE
Practice Address - Street 2:RMC FERRIDAY CLINIC
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-2826
Practice Address - Country:US
Practice Address - Phone:318-757-0210
Practice Address - Fax:318-757-0244
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD203562208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
HID43462Medicare UPIN