Healthcare Provider Details

I. General information

NPI: 1679539969
Provider Name (Legal Business Name): MARC R LAUFER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST BRIGHAM AND WOMENS HOSPITAL
BOSTON MA
02115-6110
US

IV. Provider business mailing address

75 FRANCIS ST BRIGHAM AND WOMEN'S HOSPITAL
BOSTON MA
02115-6110
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-4222
  • Fax:
Mailing address:
  • Phone: 617-732-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number59282
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG073488
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: