Healthcare Provider Details
I. General information
NPI: 1306800859
Provider Name (Legal Business Name): MARSHALL FRANCIS LAUER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/13/2006
Last Update Date: 02/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
414 HADDON AVE
COLLINGSWOOD NJ
08108-1330
US
IV. Provider business mailing address
1415 MARLTON PIKE E STE LL5
CHERRY HILL NJ
08034-2229
US
V. Phone/Fax
- Phone: 856-854-7800
- Fax: 856-854-1687
- Phone: 856-285-7200
- Fax: 856-285-7201
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | 25MA03922400 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 25MA03922400 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: