Healthcare Provider Details

I. General information

NPI: 1861418337
Provider Name (Legal Business Name): LINDA LAU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NO. 16TH ST.
NEW CASTLE IN
47362-4319
US

IV. Provider business mailing address

PO BOX 445
NEW CASTLE IN
47362-0445
US

V. Phone/Fax

Practice location:
  • Phone: 765-521-1135
  • Fax: 765-521-1331
Mailing address:
  • Phone: 317-776-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01027804A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: