Healthcare Provider Details

I. General information

NPI: 1376569525
Provider Name (Legal Business Name): LAURIE JANE POSS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 03/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 DEFENSE HWY SUITE 211
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

133 DEFENSE HWY SUITE 211
ANNAPOLIS MD
21401
US

V. Phone/Fax

Practice location:
  • Phone: 410-571-0904
  • Fax: 410-571-0905
Mailing address:
  • Phone: 410-571-0904
  • Fax: 410-571-0905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD32567
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberD00032567
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberD32567
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: