MEDICARE: DR. LAUREN B. RICHTER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	O0036547	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	080171386	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8110692	OTHER	MD	MAMSI PRIMARY CARE
2	026151	OTHER	MD	JHHC PROVIDER NUMBER
3	4201552	OTHER	MD	AETNA FEE FOR SERVICE
4	2313913	OTHER	MD	AETNA CAPITATED
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1180123	OTHER	MD	CIGNA PIN
7	P14862	OTHER	MD	CAREFIRST MPOS
9	2110692	OTHER	MD	MAMSI SPECIALIST
10	7605-0047	OTHER	MD	CAREFIRST BLUECHOICE
11	529272-07	OTHER	MD	CAREFIRST MD RENDERING

General Provider Information

NPI Number	:	1366434227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN B. RICHTER D.O.

Provider Business Mailing Address
First Line	:	29 S PACA ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-1771
Country	:	US
Telephone Number	:	410-448-6772
Fax Number	:	410-448-1873

Provider Business Practice Location Address
First Line	:	2200 KERNAN DR
Second Line	:	SECOND FLOOR
City	:	BALTIMORE
State	:	MD
Zip	:	21207-6665
Country	:	US
Telephone Number	:	410-448-6361
Fax Number	:	410-448-1873

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	07/29/2008

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Directions to “ DR. LAUREN B. RICHTER D.O.” Practice Location

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