Healthcare Provider Details

I. General information

NPI: 1023017563
Provider Name (Legal Business Name): DENISE H. LAURIENTI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 HIGHLAND OAKS DR SUITE 201
WINSTON-SALEM NC
27103-7108
US

IV. Provider business mailing address

730 HIGHLAND OAKS DR STE 201
WINSTON SALEM NC
27103-7108
US

V. Phone/Fax

Practice location:
  • Phone: 336-768-2425
  • Fax: 336-768-4915
Mailing address:
  • Phone: 336-768-2425
  • Fax: 336-768-4915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number83513
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number83513
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: