Provider Demographics
NPI:1861505067
Name:LAUER, LONNIE C (DO)
Entity Type:Individual
Prefix:DR
First Name:LONNIE
Middle Name:C
Last Name:LAUER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SHORE ACRES
Mailing Address - Street 2:
Mailing Address - City:BRIDGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04009-3543
Mailing Address - Country:US
Mailing Address - Phone:207-647-5482
Mailing Address - Fax:
Practice Address - Street 1:77 BATES ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7637
Practice Address - Country:US
Practice Address - Phone:207-753-3080
Practice Address - Fax:207-753-3291
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME8582083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME077470Medicare ID - Type Unspecified
MEF19556Medicare UPIN