Provider Demographics
NPI:1366434227
Name:RICHTER, LAUREN B (DO)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:B
Last Name:RICHTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:29 S PACA ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1771
Mailing Address - Country:US
Mailing Address - Phone:410-448-6772
Mailing Address - Fax:410-448-1873
Practice Address - Street 1:2200 KERNAN DR
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-6665
Practice Address - Country:US
Practice Address - Phone:410-448-6361
Practice Address - Fax:410-448-1873
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDO0036547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8110692OtherMAMSI PRIMARY CARE
MD026151OtherJHHC PROVIDER NUMBER
MD4201552OtherAETNA FEE FOR SERVICE
MD2313913OtherAETNA CAPITATED
MD646861600Medicaid
MD1180123OtherCIGNA PIN
MDP14862OtherCAREFIRST MPOS
080171386OtherRR MEDICARE
MD2110692OtherMAMSI SPECIALIST
MD7605-0047OtherCAREFIRST BLUECHOICE
MD529272-07OtherCAREFIRST MD RENDERING
MD226LA824Medicare PIN
MD8110692OtherMAMSI PRIMARY CARE