1437198769 NPI number — DR. LAURIE DEANN KAISER SUND M.D.

Table of content: DR. LAURIE DEANN KAISER SUND M.D. (NPI 1437198769)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437198769 NPI number — DR. LAURIE DEANN KAISER SUND M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAISER SUND
Provider First Name:
LAURIE
Provider Middle Name:
DEANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437198769
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
514 SAINT PETER ST
Provider Second Line Business Mailing Address:
GALLERY TOWERS, SUTIE 200
Provider Business Mailing Address City Name:
SAINT PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55102-1001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-326-3600
Provider Business Mailing Address Fax Number:
651-326-3626

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
514 SAINT PETER ST
Provider Second Line Business Practice Location Address:
GALLERY TOWERS, SUTIE 200
Provider Business Practice Location Address City Name:
SAINT PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55102-1001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-326-3600
Provider Business Practice Location Address Fax Number:
651-326-3626
Provider Enumeration Date:
06/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  40720 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1066910 . This is a "AMERICA'S PPO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 244291019819 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP27083 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: P00207478 . This is a "RR MEDICARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 289K7SU . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0118264 . This is a "SELECT CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: MEDICA . This is a "0118264" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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