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General NPI Number Information
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NPI Number | 1326331760
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Entity Type | Individual
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Provider Name | LAURIAN ROEDIGER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 505 OBERLIN RD
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City | RALEIGH
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State | NC
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Zip | 27605-1327
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Country | US
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Telephone | 919-235-6514
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Fax |
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Provider Business Mailing Address
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Address Line | 505 OBERLIN RD STE 230
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City | RALEIGH
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State | NC
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Zip | 27605-1345
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Country | US
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Telephone | 919-235-6514
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 48324
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2018-00932
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License Number State | NC
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