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General NPI Number Information
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NPI Number | 1831400043
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Entity Type | Individual
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Provider Name | LAQUANDA TRAVON KNOWLIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 601 CHILDRENS LN
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City | NORFOLK
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State | VA
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Zip | 23507-1910
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Country | US
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Telephone | 757-668-7703
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Fax | 757-668-8860
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Provider Business Mailing Address
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Address Line | 4650 W SUNSET BLVD MAILSTOP#175
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City | LOS ANGELES
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State | CA
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Zip | 90027-6062
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Country | US
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Telephone | 705-979-9427
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | LL32879
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 102167
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101255183
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License Number State | VA
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