Douglass, Laurie M
Douglass, Laurie M is an individual health care provider with primary practice located at 725 Albany St Shapiro 8, Boston MA 02118-2526. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is her primary health care specialty. Douglass, Laurie M can be contacted via phone (617) 414-4841.Contact Information
Primary practice address
725 Albany St Shapiro 8
Boston MA 02118-2526
Phone: (617) 414-4841
Fax: (617) 414-4502
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 159823 | Massachusetts |
| Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology | 2084N0402X | 159823 | Massachusetts |
Profile Details
| NPI number | 1124017975 |
|---|---|
| LBN Legal business name | Douglass, Laurie M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2005 |
| Last updated | Oct 28th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124017975 | NPPES |
| Massachusetts | MEDICAID | 110061538A |
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