Provider Demographics
NPI:1881687853
Name:LAMAR, LAURA M (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:LAMAR
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:32743 23 MILE RD
Mailing Address - Street 2:STE 210
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-1985
Mailing Address - Country:US
Mailing Address - Phone:586-725-3444
Mailing Address - Fax:586-725-0984
Practice Address - Street 1:32743 23 MILE RD
Practice Address - Street 2:STE 210
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-1985
Practice Address - Country:US
Practice Address - Phone:586-725-3444
Practice Address - Fax:586-725-0984
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5901002008213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5213512Medicaid
MI5213512Medicaid
0E06226010Medicare PIN
MIU85839Medicare UPIN