Provider Demographics
NPI:1124128681
Name:HARTING, LAUREN WOODHOUSE (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:WOODHOUSE
Last Name:HARTING
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 1:1356 SOUTH LAKE PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342
Mailing Address - Country:US
Mailing Address - Phone:219-942-8518
Mailing Address - Fax:219-947-2751
Practice Address - Street 1:1356 SOUTH LAKE PARK AVENUE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342
Practice Address - Country:US
Practice Address - Phone:219-942-8518
Practice Address - Fax:219-947-2751
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059320A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INI19263Medicare UPIN
IN471340Medicare PIN