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General NPI Number Information
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NPI Number | 1821449885
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Entity Type | Organization
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Legal Business Name | LAUGHLIN PLASTIC SURGERY, LLC
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Dates
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Enumeration Date | 06/30/2016
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Last Update Date | 06/30/2016
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Provider Practice Location Address
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Address Line | 166 DEFENSE HWY SUITE 101
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7034
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Country | US
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Telephone | 410-224-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 166 DEFENSE HWY SUITE 101
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7034
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Country | US
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Telephone | 410-224-2020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARL DANIEL LAUGHLIN
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Credential | M.D.
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Telephone | 410-224-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D34629
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License Number State | MD
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