Provider Demographics
NPI:1467649517
Name:LAUER VISION
Entity type:Organization
Organization Name:LAUER VISION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-676-1010
Mailing Address - Street 1:1812 PULASKI HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1697
Mailing Address - Country:US
Mailing Address - Phone:410-676-1010
Mailing Address - Fax:410-676-0085
Practice Address - Street 1:1812 PULASKI HWY
Practice Address - Street 2:SUITE A
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1697
Practice Address - Country:US
Practice Address - Phone:410-676-1010
Practice Address - Fax:410-676-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12244598156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty