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Individual
DR. LAURIE UPTON DE GRAND
Active
Individual
DR. LAURIE UPTON DE GRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101250763
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
0101250763
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-002
TRICARE/CHAMPUS
VA
01
—
10085658
OPTIMA HEALTH
VA
01
—
1922204759
UNITED HEALTHCARE
VA
05
—
1922204759
—
VA
01
—
448890
ANTHEM BC/BS
VA
05
—
5918931
—
NC
01
—
PAR
AETNA
VA
Enumeration date
06/27/2007
Last updated
06/01/2021
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