Provider Demographics
NPI:1164650594
Name:WALTERS, LAURA LESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LESLEY
Last Name:WALTERS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:26901 BEAUMONT BLVD.
Mailing Address - Street 2:STE. 3D
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1867
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:1500 EAST MEDICAL CENTER DR
Practice Address - Street 2:2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5054
Practice Address - Country:US
Practice Address - Phone:800-086-2728
Practice Address - Fax:734-615-2964
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2019-01-17
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Provider Licenses
StateLicense IDTaxonomies
MI4301094376207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology