Provider Demographics
NPI:1679922686
Name:LASURE, BEN (MD)
Entity type:Individual
Prefix:DR
First Name:BEN
Middle Name:
Last Name:LASURE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:ROOM 7400 PO BOX 9149
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-9149
Mailing Address - Country:US
Mailing Address - Phone:304-293-7215
Mailing Address - Fax:304-293-6702
Practice Address - Street 1:1 MEDICAL CENTER DR ROOM 7400
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-9149
Practice Address - Country:US
Practice Address - Phone:304-293-7215
Practice Address - Fax:304-293-6702
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV28019207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine