MEDICARE: DR. LORIN STAR ODEN AUD

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	231H00000X	Audiologist	2194	NC
2	237600000X	Audiologist-Hearing Aid Fitter	2194	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255457511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORIN STAR ODEN AUD

Provider Business Mailing Address
First Line	:	464 JAKE ALEXANDER BLVD WEST
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28147-1365
Country	:	US
Telephone Number	:	704-633-0023
Fax Number	:	704-705-2363

Provider Business Practice Location Address
First Line	:	464 JAKE ALEXANDER BLVD WEST
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28147-1365
Country	:	US
Telephone Number	:	704-633-0023
Fax Number	:	704-705-2363

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	04/22/2014

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Directions to “ DR. LORIN STAR ODEN AUD” Practice Location

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