# DR. LAURIE UPTON DE GRAND

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1922204759
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101250763 | VA | — |
| 207V00000X | Obstetrics & Gynecology Physician | 0101250763 | VA | Yes |

## Other

- **Enumeration date:** 06/27/2007
- **Last updated:** 06/01/2021

## 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 |