Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 15568 | HI |
N | 207P00000X | Emergency Physician | 30400 | OK |
NPI | 1013137280 |
---|---|
Provider Name | Dr. Timothy Christopher Laeger |
First Address | Honolulu, HI 96825-3415 |
Second Address | Honolulu, HI 96813-3097 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2007 |
Last Update Date | 29/10/2014 |