Provider Demographics
NPI:1427250323
Name:REAVEN, LAURA BABKES (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BABKES
Last Name:REAVEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7226 LEE DEFOREST DR STE 102
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3239
Mailing Address - Country:US
Mailing Address - Phone:410-730-6911
Mailing Address - Fax:410-730-1599
Practice Address - Street 1:7226 LEE DEFOREST DR STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3239
Practice Address - Country:US
Practice Address - Phone:410-730-6911
Practice Address - Fax:410-730-1599
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2024-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD732502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD233276ZETBMedicare PIN