Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 10756383-1205 | UT |
Y | 207X00000X | Orthopaedic Surgeon | 71737 | WI |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 10756383-1205 | UT |
NPI | 1639512056 |
---|---|
Provider Name | Laura L Bellaire |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53711-1074 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2013 |
Last Update Date | 21/01/2021 |