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1649599598

NPI Code Detail

MEDICARE: LAURA THORNE EKKA MD

MEDICARE: LAURA THORNE EKKA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	2014-00284	NC
2	208000000X	Pediatrics Physician	2014-00284	NC

General Provider Information

NPI Number	:	1649599598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA THORNE EKKA MD

Provider Business Mailing Address
First Line	:	4801 GLENWOOD AVE STE 200
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27612-3857
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 GLENWOOD AVE STE 200
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27612-3857
Country	:	US
Telephone Number	:	919-235-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2010
Last Update Date	:	05/05/2026

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Directions to “ LAURA THORNE EKKA MD” Practice Location

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