Provider Demographics
NPI:1447344692
Name:HASTINGS-WOOD, LAURA ANN (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:HASTINGS-WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 CAMDEN RD STE 107-259
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4690
Mailing Address - Country:US
Mailing Address - Phone:240-566-1639
Mailing Address - Fax:770-701-6718
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203
Practice Address - Country:US
Practice Address - Phone:240-566-1639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86027207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G860270Medicaid
CA00G860270 F91OtherCAL OPTIMA
CAG23118Medicare UPIN
CAWG86027AMedicare ID - Type Unspecified