Healthcare Provider Details

I. General information

NPI: 1154647543
Provider Name (Legal Business Name): LAUREN MINOR FITZPATRICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN STEPHANIE MINOR MD

II. Dates (important events)

Enumeration Date: 04/11/2010
Last Update Date: 05/19/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MEDICAL PKWY
ANNAPOLIS MD
21401-3773
US

IV. Provider business mailing address

2001 MEDICAL PARKWAY PEDIATRICS
ANNAPOLIS MD
21401-3773
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-6200
  • Fax:
Mailing address:
  • Phone: 433-481-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD75579
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: