Individual
LAURA KELLY MAVITY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 NE NEFF RD, ST. CHARLES MEDICAL CENTER - BEND, BEND, OR 97701-6015
(541) 706-5880
Mailing address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 706-5880
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD25707
OR
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
MD25707
OR
Other
Enumeration date
10/27/2006
Last updated
04/17/2020
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