MEDICARE: DR. LAURENCE S WEBSTER MD PC

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	207Q00000X	Family Medicine Physician	9500269	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9500269	OTHER	NC	STATE LICENSE
2	141TA	OTHER	NC	BCBS NC
3	352013623	OTHER	NC	TAX ID

General Provider Information

NPI Number	:	1982781621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURENCE S WEBSTER MD PC

Provider Business Mailing Address
First Line	:	3605 PETERS CT
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9004
Country	:	US
Telephone Number	:	336-841-1850
Fax Number	:	336-841-1855

Provider Business Practice Location Address
First Line	:	3605 PETERS CT
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9004
Country	:	US
Telephone Number	:	336-841-1850
Fax Number	:	336-841-1855

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	06/27/2008

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Directions to “ DR. LAURENCE S WEBSTER MD PC” Practice Location

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