Individual
AGNES M LAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12680 OLIVE BLVD STE 116, SAINT LOUIS, MO 63141-6322
(314) 529-5660
(314) 529-5665
Mailing address
12680 OLIVE BLVD STE 116, SAINT LOUIS, MO 63141-6322
(314) 529-5660
(314) 529-5665
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2024044616
MO
208000000X
Pediatrics Physician
35070728L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000323677
ANTHEM
—
05
—
0273396
—
OH
01
—
510450201027
CARESOURCE
—
Enumeration date
12/20/2005
Last updated
04/02/2025
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