Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 4301027068 | MI |
Y | 207RI0200X | Infectious Disease | 4301027068 | MI |
NPI | 1861452567 |
---|---|
Provider Name | Carl Lauter |
First Address | Troy, MI 48083-1103 |
Second Address | Royal Oak, MI 48073-6710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2006 |
Last Update Date | 23/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1342253 | (05) | MI |
440F361390 | BCBSM (01) | MI |
B48540 | (02) | MI |