Provider Demographics
NPI:1053350900
Name:MICHAEL K LAIDLAW MD, INC.
Entity type:Organization
Organization Name:MICHAEL K LAIDLAW MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:LAIDLAW
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:916-315-9100
Mailing Address - Street 1:4770 ROCKLIN RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-3334
Mailing Address - Country:US
Mailing Address - Phone:916-315-9100
Mailing Address - Fax:916-315-0141
Practice Address - Street 1:4770 ROCKLIN RD
Practice Address - Street 2:SUITE #1
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3334
Practice Address - Country:US
Practice Address - Phone:916-315-9100
Practice Address - Fax:916-315-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81060207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty