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NPI Code Detail

MEDICARE: LAURA MESA LABOONE MD

MEDICARE:   LAURA MESA LABOONE  MD
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
1174400000XSpecialist36636SC

General Provider Information

NPI Number : 1932364767
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA MESA LABOONE MD
Provider Business Mailing Address
First Line : 1740 SAINT JULIAN PL
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-2410
Country : US
Telephone Number : 803-256-3534
Fax Number : 803-254-7032
Provider Business Practice Location Address
First Line : 1740 SAINT JULIAN PL
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-2410
Country : US
Telephone Number : 803-256-3534
Fax Number : 803-254-7032
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2008
Last Update Date : 12/10/2025

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Directions to “ LAURA MESA LABOONE MD” Practice Location

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