Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Laura Woodbeck Moustafa

Individual provider Pediatrics Physician · NPI 1003236704

Laura Woodbeck Moustafa is a Pediatrics Physician in Maple Grove, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

12720 Bass Lake Rd
Maple Grove, MN 55369-6307
Phone: (763) 559-2861
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 61732 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1003236704
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 21, 2014
Last updated in NPPESMay 11, 2021
Certification dateMay 11, 2021

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