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General NPI Number Information
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NPI Number | 1700844016
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Entity Type | Individual
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Provider Name | LAURA ALOIS CHARETTE MD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 12/07/2012
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Provider Practice Location Address
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Address Line | 2021 CONCERT DR SUITE 202
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-8082
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Country | US
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Telephone | 757-453-6711
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Fax | 757-301-6496
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Provider Business Mailing Address
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Address Line | 917 GREAT MARSH AVE
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City | CHESAPEAKE
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State | VA
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Zip | 23320-0682
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Country | US
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Telephone | 757-548-0953
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101046939
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License Number State | VA
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