Healthcare Provider Details

I. General information

NPI: 1457514333
Provider Name (Legal Business Name): LAURA COWEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 09/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 33RD ST 33RD STREET PROFESSIONAL BUILDING, SUITE 551
BALTIMORE MD
21218-3322
US

IV. Provider business mailing address

200 E 33RD ST 33RD STREET PROFESSIONAL BUILDING, SUITE 551
BALTIMORE MD
21218-3322
US

V. Phone/Fax

Practice location:
  • Phone: 410-554-4511
  • Fax:
Mailing address:
  • Phone: 410-554-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD74749
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: