Individual
ALLAN R LAREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2680 W CENTRE AVE, PORTAGE, MI 49024-4828
(269) 324-2400
(269) 324-0450
Mailing address
2680 W CENTRE AVE, PORTAGE, MI 49024-4828
(269) 324-2400
(269) 324-0450
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301035589
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417961137
BCBSM - BMH
MI
05
—
1922078575
—
MI
05
—
3205128
—
MI
05
—
4467350
—
MI
Enumeration date
01/25/2006
Last updated
10/16/2014
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