Healthcare Provider Details

I. General information

NPI: 1053352146
Provider Name (Legal Business Name): RICHARD C LAUER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 CAMINO DE SALUD NE UNM CANCER CENTER
ALBUQUERQUE NM
87106
US

IV. Provider business mailing address

933 BRADBURY SE, SUITE 2222
ALBUQUERQUE NM
87106
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-4946
  • Fax: 505-272-8060
Mailing address:
  • Phone: 505-272-3120
  • Fax: 505-272-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD2007-0130
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: