Provider Demographics
NPI:1629184403
Name:BLACK-FARRAR, LAURA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANN
Last Name:BLACK-FARRAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:BROWN
Other - Last Name:CURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9003 YELLOW PINE CT
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8376
Mailing Address - Country:US
Mailing Address - Phone:980-236-1860
Mailing Address - Fax:704-440-4691
Practice Address - Street 1:10021 PARK CEDAR DR STE D28210
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8700
Practice Address - Country:US
Practice Address - Phone:980-236-1860
Practice Address - Fax:704-440-4691
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97-01305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine