Provider Demographics
NPI:1205881737
Name:BACHMANN, LAURA H (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:H
Last Name:BACHMANN
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 344
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27102-0344
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01690207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009931635Medicaid
AL051517241OtherBLUE CROSS
AL009902895Medicaid
AL000096168OtherBLUE CROSS
AL000096168Medicaid
AL440003007OtherRAILROAD MEDICARE
ALH15936OtherVIVA
AL051510633OtherBLUE CROSS
NC5910629Medicaid
ALH15936OtherVIVA
AL000096168OtherBLUE CROSS
AL009902895Medicaid