Individual
DOUGLAS W LASKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2510 MARYLAND RD STE 185, WILLOW GROVE, PA 19090-1134
(215) 657-5886
(215) 657-9996
Mailing address
2510 MARYLAND RD STE 185, WILLOW GROVE, PA 19090-1134
(215) 657-5886
(215) 657-9996
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD055501L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015165680001
—
PA
Enumeration date
10/12/2005
Last updated
07/21/2022
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