Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD14976 | DC |
NPI | 1083726210 |
---|---|
Provider Name | Dr. Joseph P. Laukaitis |
First Address | Washington, DC 20037-2311 |
Second Address | Washington, DC 20037-1810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 22/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
437982 | MEDICARE ID (01) | DC |
AL3100055 | DEA LICENSE (01) | |
B94968 | (02) | |
CS8804004 | STATE DRUG LICENSURE (01) | DC |
MD14976 | STATE MEDICAL LICENSE (01) | DC |