Individual
DR. LAURIE B. BOTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 CLARK RD, TEWKSBURY, MA 01876-1699
(978) 453-9272
(978) 970-1506
Mailing address
600 CLARK RD, TEWKSBURY, MA 01876-1699
(978) 453-9272
(978) 970-1506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46137
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-00704
UNITED HEALTHCARE
MA
05
—
0154008
—
MA
01
—
30002667
MEDICAID NEW HAMPSHIRE
NH
01
—
6727439
CIGNA HEALTHCARE
MA
01
—
701208
TUFTS
MA
01
—
7662
HARVARD PILGRIM
MA
01
—
92117
AETNA INDIVIDUAL #
MA
01
—
B46048
BL CRS BL SHLD INDIV #
MA
Enumeration date
03/17/2007
Last updated
07/09/2007
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