Individual
LAURA KELLAM PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
280 CHARLES DIMMOCK PKWY, SUITE 4, COLONIAL HEIGHTS, VA 23834-2940
(804) 526-7364
(804) 526-7394
Mailing address
301 CONCOURSE BLVD, SUITE 190, GLEN ALLEN, VA 23059-5643
(804) 549-4030
(804) 549-4032
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101231692
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010008280
—
VA
01
—
0300585
UNITED HEALTHCARE
—
01
—
230056
SOUTHERN HEALTH
—
01
—
465745
ANTHEM
—
01
—
7442479
AETNA
—
01
—
P00047267
RAILROAD MEDICARE
—
Enumeration date
07/28/2005
Last updated
07/31/2014
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