Powers, Lara M
Powers, Lara M is an individual health care provider with primary practice located at 1409 Cleveland Ave , Marinette WI 54143-3918. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Powers, Lara M can be contacted via phone (715) 732-0832.Contact Information
Primary practice address
1409 Cleveland Ave
Marinette WI 54143-3918
Phone: (715) 732-0832
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 45322020 | Wisconsin |
Profile Details
| NPI number | 1730176140 |
|---|---|
| LBN Legal business name | Powers, Lara M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Apr 6th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730176140 | NPPES |
| Wisconsin | MEDICAID | 34346300 | |
| Wisconsin | Other | P00104680 |
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