Provider Demographics
NPI:1750473856
Name:HERSCHER, LAURIE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:
Last Name:HERSCHER
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:PO BOX 418837
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8837
Mailing Address - Country:US
Mailing Address - Phone:301-309-6765
Mailing Address - Fax:301-309-2230
Practice Address - Street 1:11006 VEIRS MILL RD STE L1
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2587
Practice Address - Country:US
Practice Address - Phone:301-681-4422
Practice Address - Fax:301-681-1684
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00404402085R0001X
IL0361668902085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0344277-00Medicaid
MD3040740OtherAETNA HMO
21225933862OtherBEECH STREET
MD7782438OtherAETNA PPO/POS
0994125001OtherCIGNA
MD4342194-00Medicaid
2006597OtherFIRST HEALTH
MD434219400Medicaid
105852OtherAMERIGROUP
2196482OtherUNITED HEALTHCARE
DCS357-0003OtherCAREFIRST BC/BS DC
DC530306OtherNATIONAL CAPITOL PPO
MD613717-01OtherCAREFIRST BC/BS MD
MD613717-01OtherCAREFIRST BC/BS MD
MD4342194-00Medicaid
MD228067ZAWAMedicare PIN
MI009485S56Medicare PIN
MD434219400Medicaid