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Individual

KEVIN LAWRENCE LASER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
512 BENFOREST DR, SEVERNA PARK, MD 21146-1735
(410) 544-7611
(410) 544-5179
Mailing address
512 BENFOREST DR, SEVERNA PARK, MD 21146-1735
(410) 544-7611
(410) 544-5179

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D35560
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15-00070
EVERCARE
01
52471105
CAREFIRST BCBS
MD
05
751621500
MD
01
K749
BCBS NATIONAL, FEP, BLUECHOICE
DC
Enumeration date
09/14/2005
Last updated
05/27/2008
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