Provider Demographics
NPI:1275708604
Name:WOOD, LAURA DELONG
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:DELONG
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 CATHEDRAL ST
Mailing Address - Street 2:APT 51
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5245
Mailing Address - Country:US
Mailing Address - Phone:443-831-5884
Mailing Address - Fax:
Practice Address - Street 1:701 CATHEDRAL ST
Practice Address - Street 2:APT 51
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5245
Practice Address - Country:US
Practice Address - Phone:443-831-5884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-27
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD73452207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology