Provider Demographics
NPI:1669978136
Name:BARBOUR, LAURA M (DO)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 TANEY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5126
Mailing Address - Country:US
Mailing Address - Phone:301-662-0133
Mailing Address - Fax:
Practice Address - Street 1:1475 TANEY AVE STE 201
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-5126
Practice Address - Country:US
Practice Address - Phone:301-662-0133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH91234208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics