Doctor Name: | CHARLES WILLIAM LAIS |
NPI Number: | 1053387456 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 29597 |
Business Practice Address: | 530 3rd St Nw Mail Stop 39400a Elk River, MN - 553301445 |
Business Phone Number: | 7637126000 |
Business Fax Number: | 7637126591 |
Mailing Address: | 8100 34th Ave S, 21110q BLOOMINGTON |
State: | MN |
Postal Code: | 554251672 |
Phone Number: | 9528835790 |
Fax Number: | 9528835395 |
NPI Enumeration Date: | 02/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 29597 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |