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Individual

LAURA KATHLEEN MAIORANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1221 PINE GROVE AVE, EMERGENCY DEPARTMENT, PORT HURON, MI 48060-3511
(810) 989-3300
(810) 985-2671
Mailing address
3050 COMMERCE DR, FORT GRATIOT, MI 48059-3819
(810) 385-4441
(810) 385-1540

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006495
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629328455
MI
Enumeration date
09/19/2012
Last updated
10/09/2012
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