Basic Information
| Provider Information | |||||||||
| NPI: | 1063918043 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOUENOU | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | OREDOLA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7501 SURRATTS RD DEPT OF | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207353362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012920236 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7501 SURRATTS RD | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207353362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018777200 | ||||||||
| FaxNumber: | 3018775405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2018 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | D0094471 | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.