Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 0101238821 | MA |
N | 207ND0900X | Dermatopathologist | 0101238821 | MA |
NPI | 1053474759 |
---|---|
Provider Name | Dr. Laura Elizabeth Regan |
First Address | Richmond, VA 23235-8017 |
Second Address | Midlothian, VA 23113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 07/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1178927 | AETNA HMO (01) | VA |
192334 | ANTHEM (01) | VA |
7682749 | AETNA NON-HMO (01) | VA |