Individual
LAUREL CLAIRE BLAKEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3023 HAMAKER CT STE 200, FAIRFAX, VA 22031-2240
(703) 848-6627
Mailing address
3023 HAMAKER CT STE 200, FAIRFAX, VA 22031-2240
(703) 848-6627
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME117758
FL
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
0101236348
VA
207XP3100X
Pediatric Orthopaedic Surgery Physician
MD034954
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009880000
—
FL
Enumeration date
10/13/2006
Last updated
08/27/2020
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