Provider Demographics
NPI:1376569525
Name:POSS, LAURIE JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:JANE
Last Name:POSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:133 DEFENSE HWY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:410-571-0904
Mailing Address - Fax:410-571-0905
Practice Address - Street 1:133 DEFENSE HWY
Practice Address - Street 2:SUITE 211
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:410-571-0904
Practice Address - Fax:410-571-0905
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00032567207QA0401X
MDD32567207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD383821800Medicaid
MDD00032567OtherMEDICAL LICENSE
MDB67299Medicare UPIN
MD7478Medicare ID - Type Unspecified