Individual
DR. LAURA ANNE BOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 E MARSHALL ST, RICHMOND, VA 23298-5051
(804) 828-3500
(804) 828-8606
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
0101252572
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101262572
MEDICAL LICENSE
VA
Enumeration date
03/16/2007
Last updated
03/07/2023
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