LAUREL MEDICAL GROUP, LLC (NPI# 1477640696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477640696 |
| Entity Type | Organization |
| Organization Name | LAUREL MEDICAL GROUP, LLC |
| Practice Address |
1124 S Central Ave Laurel DE 19956-1418 |
| Mailing Address |
66 Rivers End Dr Seaford DE 19973-8011 |
| Practice Telephone | 3028757753 |
| Mailing Telephone | 3026283018 |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ANTONIO PEDRO (CO-OWNER) |
| Authorized Official Telephone | 3028757753 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207R00000X | Internal Medicine | C1-0005393 | DE | Allopathic & Osteopathic Physicians |
| X | 207RN0300X |
Internal Medicine Specialization: Nephrology |
C1-0004999 | DE | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801412408 | Laurel Medical Group, LLC | Internal Medicine | 5911 Ne 14th Ln, 104, Fort Lauderdale, FL 33334 | 2020-06-19 |
| Street Address |
1124 S CENTRAL AVE |
| City | LAUREL |
| State | DE |
| Zip Code | 19956-1418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073021911 | Arlene Patricia Wood | Counselor | 517 Willow Street, Laurel, DE 19956 | 2018-01-12 |
| 1356897094 | Abigail Siple | Speech-Language Pathologist | 1160 South Central Ave, Laurel, DE 19956 | 2016-09-01 |
| 1750739207 | Erin Johnson | Specialist/Technologist | 14323 Laurel Rd, Laurel, DE 19956 | 2016-05-25 |
| 1922192434 | Antonio Pedro | Internal Medicine | 1124 South Central Ave, Laurel, DE 19956 | 2006-10-02 |
| 1043311095 | Shellene Marie Ball | Psychologist | 11023 Joe Warrington Dr, Laurel, DE 19956 | 2006-09-25 |
| 1972670479 | Janice M Mccandless Bruce | Registered Nurse | 11023 Joe Warrington Dr, Laurel, DE 19956 | 2006-11-29 |
| 1093800401 | Odilon Claravall | Internal Medicine | 1124 South Central Ave, Laurel, DE 19956 | 2006-10-03 |
| 1396804829 | Laurel Senior Center, Inc. | Psychologist | 113 N. Central Ave., Laurel, DE 19956-0064 | 2006-12-08 |
| 1326174699 | Kathy Guthrie | Counselor | 111 Mechanic St, Laurel, DE 19956-1004 | 2007-02-23 |
| 1588984769 | Raffaela Ballard | Counselor | 111 Mechanic St, Laurel, DE 19956-1004 | 2010-06-10 |
| Find all providers in zip 19956 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003203134 | Erica Nakajima | Internal Medicine | 323 Laurel Ave, Laurel, MD 20707-4319 | 2015-04-15 |
| 1124457726 | Mid-atlantic Medical | Internal Medicine | 9248 Stream View Ln, Laurel, MD 20723-1890 | 2013-11-04 |
| 1881966851 | Solomon Feyissa LLC | Internal Medicine | 14740 4th St, Apt 415, Laurel, MD 20707-3718 | 2012-02-06 |
| 1942468152 | Ratnakanth Mohanrao Siddabattula | Internal Medicine | 13504 Attleboro Ct, Apt # 21, Laurel, MD 20708-1557 | 2008-05-26 |
| 1255511655 | Rita Pabla Md | Internal Medicine | 13621 Baltimore Ave, Laurel, MD 20707-5095 | 2007-11-14 |
| 1740390012 | Syed Akbar Ali Sadiq | Internal Medicine | 14333 Laurel Bowie Road, Suite 208, Laurel, MD 20708-1179 | 2006-08-30 |
| 1215960703 | Abdul Munim | Internal Medicine | 8379 Cherry Ln, Laurel, MD 20707-4831 | 2006-07-08 |
| 1699722009 | Prema Siva | Internal Medicine | 8871 Gorman Rd Ste 300, Laurel, MD 20723-5877 | 2006-05-30 |
| 1497702302 | David L Harrison | Internal Medicine | 1203 Jefferson St, Laurel, MS 39440-4354 | 2006-05-27 |
| 1013978790 | Darryl A Hill | Internal Medicine | 13635 Baltimore Ave, Laurel, MD 20707 | 2006-03-31 |
| Find all providers in LAUREL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.