Provider Demographics
NPI:1629114657
Name:LAURIE J. POSS, M.D. P.A.
Entity Type:Organization
Organization Name:LAURIE J. POSS, M.D. P.A.
Other - Org Name:ADDICTIONS TREATMENT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:POSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-571-0904
Mailing Address - Street 1:133 DEFENSE HIGHWAY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7378
Mailing Address - Country:US
Mailing Address - Phone:410-571-0904
Mailing Address - Fax:410-571-0905
Practice Address - Street 1:133 DEFENSE HIGHWAY
Practice Address - Street 2:SUITE 211
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7378
Practice Address - Country:US
Practice Address - Phone:410-571-0904
Practice Address - Fax:410-571-0905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032567207Q00000X, 207QA0000X
MDD00032567207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Single Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD383821800Medicaid
MDB67299Medicare UPIN
MD383821800Medicaid