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Individual

LAURA A JOQUE

Active
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Individual

LAURA A JOQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47011
MN
207RH0000X
Hematology (Internal Medicine) Physician
47011
MN
207RH0003X
Hematology & Oncology Physician
MD27329
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006200
OR
05
074970200
MN
05
ENROLLED
IA
05
ENROLLED
MN
01
P00198296
RAILROAD MEDICARE
MN
Enumeration date
01/17/2006
Last updated
01/08/2016
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