Provider Demographics
NPI:1679839641
Name:HIGGINBOTHAM, LAURA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:HIGGINBOTHAM
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 7TH ST NW APT 414
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3265
Mailing Address - Country:US
Mailing Address - Phone:540-319-1337
Mailing Address - Fax:
Practice Address - Street 1:10903 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1058
Practice Address - Country:US
Practice Address - Phone:240-302-0261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012644732083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine