Provider Demographics
NPI:1790754547
Name:TRASK, LAURA E (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:E
Last Name:TRASK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:287 MAIN ST
Mailing Address - Street 2:STE. 301
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7054
Mailing Address - Country:US
Mailing Address - Phone:207-795-7520
Mailing Address - Fax:207-795-7179
Practice Address - Street 1:287 MAIN ST
Practice Address - Street 2:STE. 301
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7054
Practice Address - Country:US
Practice Address - Phone:207-795-7520
Practice Address - Fax:207-795-7179
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME016454207R00000X
MEMD16454207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME411310099Medicaid
MEME069905Medicare UPIN
MEME069903Medicare UPIN
ME411310099Medicaid