Basic Information
Provider Information | |||||||||
NPI: | 1235454240 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | DOSIER | ||||||||
FirstName: | LAURA | ||||||||
MiddleName: | BETH MANN | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2920 HIGHWOODS BLVD | ||||||||
Address2: |   | ||||||||
City: | RALEIGH | ||||||||
State: | NC | ||||||||
PostalCode: | 276040010 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8774984490 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 104 MEDSPRING DR | ||||||||
Address2: |   | ||||||||
City: | CLAYTON | ||||||||
State: | NC | ||||||||
PostalCode: | 275209687 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9192356535 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/01/2010 | ||||||||
LastUpdateDate: | 02/22/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/22/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | P6215 | TX | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 208000000X | 2014-00857 | NC | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 2080S0012X | 2014-00857 | NC | N |   | Allopathic & Osteopathic Physicians | Pediatrics | Sleep Medicine | 2080P0214X | 2014-00857 | NC | Y |   | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology |
No ID Information.