MEDICARE: LAURA ANN KRAGIE 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	207R00000X	Internal Medicine Physician	78907	MA

General Provider Information

NPI Number	:	1881652857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ANN KRAGIE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 71091
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20813-1091
Country	:	US
Telephone Number	:	301-907-6605
Fax Number	:

Provider Business Practice Location Address
First Line	:	5480 WISCONSIN AVE
Second Line	:	#1201
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3530
Country	:	US
Telephone Number	:	301-907-6605
Fax Number	:

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	07/08/2007

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