Laue, Michael R

Laue, Michael R is an sole proprietor health care provider with primary practice located at 6100 Ronald Reagan Blvd. , Lake St. Louis MO 63367. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Laue, Michael R can be contacted via phone (636) 625-2143.

Contact Information

Primary practice address
6100 Ronald Reagan Blvd. Lake St. Louis MO 63367
Fax: (636) 625-2148
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2004016783 Missouri

Profile Details

NPI number 1295707818
LBN Legal business name Laue, Michael R
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2006
Last updated Dec 11th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295707818 NPPES
Missouri MEDICAID 317192508

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