MEDICARE: DR. M. DAVID LAUTER M.D.

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	6950	NH
2	207Q00000X	Family Medicine Physician	10258	ME

General Provider Information

NPI Number	:	1366544819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. M. DAVID LAUTER M.D.

Provider Business Mailing Address
First Line	:	200 GRIFFIN RD
Second Line	:	SUITE 11
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-7145
Country	:	US
Telephone Number	:	603-433-7500
Fax Number	:	949-724-3365

Provider Business Practice Location Address
First Line	:	200 GRIFFIN RD
Second Line	:	SUITE 11
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-7145
Country	:	US
Telephone Number	:	603-433-7500
Fax Number	:	949-724-3365

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

Provider Enumeration Date	:	09/04/2006
Last Update Date	:	12/03/2021

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