Individual
LAURIE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
102 CAMPUS DR, SCARBOROUGH, ME 04074-9692
(207) 883-0069
(207) 883-0999
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD15639
ME
207VX0201X
Gynecologic Oncology Physician
Primary
MD15639
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261040099
—
ME
05
—
30202051
—
NH
Enumeration date
03/19/2007
Last updated
11/26/2014
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