Provider Demographics
NPI:1326331760
Name:ROEDIGER, LAURIAN (MD)
Entity Type:Individual
Prefix:
First Name:LAURIAN
Middle Name:
Last Name:ROEDIGER
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 1:505 OBERLIN RD STE 230
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1345
Mailing Address - Country:US
Mailing Address - Phone:919-235-6514
Mailing Address - Fax:
Practice Address - Street 1:505 OBERLIN RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1327
Practice Address - Country:US
Practice Address - Phone:919-235-6514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48324207V00000X
NC2018-00932207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology