Provider Demographics
NPI:1366544819
Name:LAUTER, M. DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:M.
Middle Name:DAVID
Last Name:LAUTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:DAVI
Other - Last Name:LAUTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 GRIFFIN RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7145
Mailing Address - Country:US
Mailing Address - Phone:603-433-7500
Mailing Address - Fax:949-724-3365
Practice Address - Street 1:200 GRIFFIN RD
Practice Address - Street 2:SUITE 11
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7145
Practice Address - Country:US
Practice Address - Phone:603-433-7500
Practice Address - Fax:949-724-3365
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6950207Q00000X
ME10258207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B86650Medicare UPIN
ME015623Medicare ID - Type Unspecified
NHRE7704Medicare ID - Type Unspecified