Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | D32567 | MD |
N | 207QA0401X | Family Doctor - Addiction Medicine | D00032567 | MD |
N | 207QA0401X | Family Doctor - Addiction Medicine | D32567 | MD |
NPI | 1376569525 |
---|---|
Provider Name | Dr. Laurie Jane Poss |
First Address | Annapolis, MD 21401 |
Second Address | Annapolis, MD 21401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 19/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
383821800 | (05) | MD |
B67299 | (02) | MD |
D00032567 | MEDICAL LICENSE (01) | MD |