Individual
LAURA JEAN MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9501010
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5413047
AETNA
NC
01
—
59778
MEDCOST
NC
01
—
59828
BCBS
NC
01
—
847472
MAMSI
NC
05
—
8959828
—
NC
Enumeration date
02/28/2006
Last updated
07/09/2021
Update your record
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