Provider Demographics
NPI:1033220819
Name:FITZPATRICK, LAURA L (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-332-5757
Mailing Address - Fax:540-332-5756
Practice Address - Street 1:78 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2332
Practice Address - Country:US
Practice Address - Phone:540-332-5757
Practice Address - Fax:540-332-5756
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053591207L00000X
DCMD31259207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC200141OtherKAISER
VA5719712Medicaid
DC0374477001OtherCIGNA HMO
MD017703200Medicaid
DC022225800Medicaid
VA441416OtherANTHEM BCBS
DC0096OtherCAREFIRST BCBS
DC7120069OtherAETNA NONHMO
DC566146OtherNCPPO
DC2608724OtherAETNA HMO