Provider Demographics
NPI:1922074079
Name:THOMAS, LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:HEIBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1821 OLD DONATION PKWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3033
Mailing Address - Country:US
Mailing Address - Phone:757-309-4081
Mailing Address - Fax:757-496-4905
Practice Address - Street 1:1821 OLD DONATION PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3033
Practice Address - Country:US
Practice Address - Phone:757-309-4081
Practice Address - Fax:757-496-4905
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032076207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1922074079Medicare PIN
VAB10100Medicare UPIN