| Shaun E Laurie Professional Association | |
|
1628 N Plaza Dr Tallahassee FL 32308-2300 | |
| (850) 309-1331 | |
| (850) 309-1332 |
| Full Name | Shaun E Laurie Professional Association |
|---|---|
| Speciality | Internal Medicine |
| Location | 1628 N Plaza Dr, Tallahassee, Florida |
| Authorized Official Name and Position | Shaun E Laurie (PRESIDENT) |
| Authorized Official Contact | 8503091331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaun E Laurie Professional Association 1628 N Plaza Dr Tallahassee FL 32308-2300 Ph: (850) 309-1331 | Shaun E Laurie Professional Association 1628 N Plaza Dr Tallahassee FL 32308-2300 Ph: (850) 309-1331 |
| NPI Number | 1396788626 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 12/28/2010 |
| Medicare PECOS PAC ID | 3173537438 |
|---|---|
| Medicare Enrollment ID | O20060126000273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396788626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shaun E Laurie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952344285 PECOS PAC ID: 4981618246 Enrollment ID: I20060127000197 |
| Provider Name | Andreas R Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891064176 PECOS PAC ID: 8729380910 Enrollment ID: I20190723000287 |
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