Individual
MIKE C. LAUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2667 E GALA CT STE 130, MERIDIAN, ID 83642-2788
(208) 855-5955
(208) 459-8628
Mailing address
2667 E GALA CT STE 130, MERIDIAN, ID 83642-2788
(208) 795-5090
(208) 459-8628
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P-274
ID
213E00000X
Podiatrist
POD000883
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000855434A
—
GA
05
—
00855434B
—
ID
05
—
00855434C
—
GA
05
—
10051376
—
GA
01
—
2308614
AETNA
GA
01
—
2600040
UNITED HEALTHCARE
GA
01
—
2701696
EVERCARE
GA
05
—
332893
—
GA
Enumeration date
01/25/2006
Last updated
09/12/2022
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