Provider Demographics
NPI:1609860998
Name:CORDES, LAURA R (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:R
Last Name:CORDES
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 1:860 OMNI BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:860 OMNI BLVD STE 110
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4430
Practice Address - Country:US
Practice Address - Phone:757-223-9794
Practice Address - Fax:757-223-9168
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0101235476207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA343762 (RICHMOND RD)OtherANTHEM
P00223452OtherRR/MEDICARE
VA010139813Medicaid
VA172185OtherANTHEM
VA010139813Medicaid
VA343762 (RICHMOND RD)OtherANTHEM