Provider Demographics
NPI:1508023854
Name:BEAUREGARD, LAURENT J (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURENT
Middle Name:J
Last Name:BEAUREGARD
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:CIANCHETTE BUILDING, SUITE 150
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-973-7357
Mailing Address - Fax:207-973-5640
Practice Address - Street 1:43 WHITING HILL RD
Practice Address - Street 2:CIANCHETTE BUILDING, SUITE 150
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1005
Practice Address - Country:US
Practice Address - Phone:207-973-7357
Practice Address - Fax:207-973-5640
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics