Provider Demographics
NPI:1942277165
Name:LAURING, SANDRA J (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:J
Last Name:LAURING
Suffix:
Gender:F
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:WASECA MEDICAL CENTER - MAYO HEALTH SYSTEM
Mailing Address - Street 2:501 N STATE ST
Mailing Address - City:WASECA
Mailing Address - State:MN
Mailing Address - Zip Code:56093
Mailing Address - Country:US
Mailing Address - Phone:507-835-1210
Mailing Address - Fax:507-837-3949
Practice Address - Street 1:WASECA MEDICAL CENTER - MAYO HEALTH SYSTEM
Practice Address - Street 2:501 N STATE ST
Practice Address - City:WASECA
Practice Address - State:MN
Practice Address - Zip Code:56093
Practice Address - Country:US
Practice Address - Phone:507-835-1210
Practice Address - Fax:507-837-3949
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2M073LAOtherBCBS
MNCN7693OtherMEDICARE - RAILROAD
MNHP16606OtherHEALTH PARTNERS
MNNA9501014021OtherPREFERRED ONE
MN2M037LAOtherBCBS
MN39-09161OtherMEDICA
MN0112735OtherMEDICA
MN114665OtherMNCARE - U
MN2M037LAOtherBCBS