Provider Demographics
NPI:1639459597
Name:SNOWER, LAUREN MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MICHELLE
Last Name:SNOWER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6308 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-5031
Mailing Address - Country:US
Mailing Address - Phone:262-551-4160
Mailing Address - Fax:262-551-4165
Practice Address - Street 1:10256 OLD GREEN BAY RD FL 3
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-2814
Practice Address - Country:US
Practice Address - Phone:262-551-4160
Practice Address - Fax:262-551-4165
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125040267207R00000X
WI82971-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine