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General NPI Number Information
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NPI Number | 1487920807
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Entity Type | Individual
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Provider Name | LAURA E AGRESTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 343 N MAPLE RD
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City | ANN ARBOR
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State | MI
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Zip | 48103-2824
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Country | US
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Telephone | 734-475-4500
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Fax | 734-475-4507
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Provider Business Mailing Address
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Address Line | 13699 E OLD US HIGHWAY 12
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City | CHELSEA
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State | MI
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Zip | 48118-9664
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Country | US
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Telephone | 734-475-4500
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Fax | 734-475-4507
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 4301501287
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301501287
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License Number State | MI
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