1255374948 NPI number — PAUL R LAUBER MD

Table of content: PAUL R LAUBER MD (NPI 1255374948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255374948 NPI number — PAUL R LAUBER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAUBER
Provider First Name:
PAUL
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255374948
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4459
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48504-0459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-424-4761
Provider Business Mailing Address Fax Number:
810-424-4871

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE HURLEY PLAZA
Provider Second Line Business Practice Location Address:
HURLEY MEDICAL CENTER, RADIOLOGY DEPT
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-424-4761
Provider Business Practice Location Address Fax Number:
810-424-4871
Provider Enumeration Date:
06/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  4301034123 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com