Individual
MARK A LAUER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3152
(612) 904-4218
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-6005
(612) 630-8242
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
046025
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53Q68LA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
06/06/2006
Last updated
07/08/2007
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