Basic Information
| Provider Information | |||||||||
| NPI: | 1316943079 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAREAU | ||||||||
| FirstName: | EUGENE | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1430 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228031430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404377989 | ||||||||
| FaxNumber: | 5404377984 | ||||||||
| Practice Location | |||||||||
| Address1: | 2006 HEALTH CAMPUS DR | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228018679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406895800 | ||||||||
| FaxNumber: | 5406895801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2005 | ||||||||
| LastUpdateDate: | 03/30/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 0101021229 | VA | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0124751000 | 05 | WV | MEDICAID | C05754 | 01 | VA | MEDICARE GROUP PTAN | OTHER | 007341755 | 05 | VA | MEDICAID | 082280 | 01 | VA | SOUTHERN HEALTH | OTHER |