Provider Demographics
NPI:1497917231
Name:YOUNG, LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:YOUNG
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 1:920 DOUG WHITE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4180
Mailing Address - Country:US
Mailing Address - Phone:854-854-7170
Mailing Address - Fax:854-854-7171
Practice Address - Street 1:920 DOUG WHITE DR STE 140
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4180
Practice Address - Country:US
Practice Address - Phone:854-854-7170
Practice Address - Fax:854-854-7171
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192625207V00000X
PAMD441466207V00000X
SC86994207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology