Individual
MICHAEL THOMAS LAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 RADIO DR, WOODBURY, MN 55125-8409
(651) 495-6865
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
73696
MN
Other
Enumeration date
03/29/2019
Last updated
08/17/2023
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