Provider Demographics
NPI:1336346386
Name:MCPEAKE, LAURA HAYES (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:HAYES
Last Name:MCPEAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9484
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02940-9484
Mailing Address - Country:US
Mailing Address - Phone:401-854-2500
Mailing Address - Fax:401-854-2519
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-519-1604
Practice Address - Fax:401-272-0538
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP00512207P00000X
IL036-119381207P00000X
RIMD12955207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIP00775372OtherRR MEDICARE
RI08-13-2009OtherNHPRI
RI1336346386OtherNPI
RI1962455022OtherGROUP NPI
RI939025129OtherGROUP RI MEDICARE
RILM76188Medicaid
RI001189101OtherMEDICARE
MA09-22-2009OtherTUFTS HEALTH PLAN
RI04-15-2009OtherUNITED HEALTHCARE