MEDICARE: LAURA ANN AMODEI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	D63801	MD

General Provider Information

NPI Number	:	1053336669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ANN AMODEI M.D.

Provider Business Mailing Address
First Line	:	277 PENINSULA FARM RD STE A
Second Line	:
City	:	ARNOLD
State	:	MD
Zip	:	21012-1018
Country	:	US
Telephone Number	:	410-544-3331
Fax Number	:	410-544-3329

Provider Business Practice Location Address
First Line	:	277 PENINSULA FARM RD STE A
Second Line	:
City	:	ARNOLD
State	:	MD
Zip	:	21012-1018
Country	:	US
Telephone Number	:	410-544-3331
Fax Number	:	410-544-3329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	10/25/2023

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