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Individual
DR. LARA M POWERS
Active
Individual
DR. LARA M POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45322020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34346300
—
WI
01
—
P00104680
RR MEDICARE
—
Enumeration date
09/30/2005
Last updated
04/06/2012
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