Provider Demographics
NPI:1669474268
Name:MARSTON, LAURIE MAY (MD)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:MAY
Last Name:MARSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2304 WESVILL CT
Mailing Address - Street 2:STE 210
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-2973
Mailing Address - Country:US
Mailing Address - Phone:919-782-6700
Mailing Address - Fax:919-782-2218
Practice Address - Street 1:2304 WESVILL CT
Practice Address - Street 2:STE 210
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-2973
Practice Address - Country:US
Practice Address - Phone:919-782-6700
Practice Address - Fax:919-782-2218
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC36223207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2190697CMedicare ID - Type Unspecified
F68062Medicare UPIN