Provider Demographics
NPI:1740540079
Name:MICHAEL, LAUREN NICOLE (DO)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:NICOLE
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:MCCROSSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:13557 STEELECROFT PARKWAY
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278
Mailing Address - Country:US
Mailing Address - Phone:704-316-1080
Mailing Address - Fax:704-316-1085
Practice Address - Street 1:13557 STEELECROFT PKWY STE 2200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-7559
Practice Address - Country:US
Practice Address - Phone:704-316-1080
Practice Address - Fax:704-316-1085
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC183486208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics