Healthcare Provider Details

I. General information

NPI: 1770726044
Provider Name (Legal Business Name): LAURA MAUREEN PEZZUTO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 WAYNE MEMORIAL DR STE I
GOLDSBORO NC
27534-1749
US

IV. Provider business mailing address

5332 CORAL VINE LN
KISSIMMEE FL
34758-2288
US

V. Phone/Fax

Practice location:
  • Phone: 919-587-3980
  • Fax: 919-587-3981
Mailing address:
  • Phone: 717-739-9885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2013-00666
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number31903
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number97529
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number84939
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME139387
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD18617
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: