Provider Demographics
NPI:1457514333
Name:COWEN, LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:COWEN
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 1:200 E 33RD ST
Mailing Address - Street 2:33RD STREET PROFESSIONAL BUILDING, SUITE 551
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3322
Mailing Address - Country:US
Mailing Address - Phone:410-554-4511
Mailing Address - Fax:
Practice Address - Street 1:200 E 33RD ST
Practice Address - Street 2:33RD STREET PROFESSIONAL BUILDING, SUITE 551
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3322
Practice Address - Country:US
Practice Address - Phone:410-554-4511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD74749207RE0101X
DCMD039719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
G4810011OtherCAREFIRST
MD060053900Medicaid
275563ZA38Medicare PIN
259826ZA84Medicare PIN