Provider Demographics
NPI:1326483884
Name:STUMP, LAURA E (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:STUMP
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 1:123 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-4227
Mailing Address - Country:US
Mailing Address - Phone:062-473-3504
Mailing Address - Fax:406-247-3389
Practice Address - Street 1:123 S 27TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4227
Practice Address - Country:US
Practice Address - Phone:062-473-3504
Practice Address - Fax:406-247-3389
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT68652207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1326483884Medicaid