Healthcare Provider Details

I. General information

NPI: 1548214893
Provider Name (Legal Business Name): MARGARET M LAYDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DOWNTOWN HEALTH CENTER 1020 N. 12TH STREET
MILWAUKEE WI
53233
US

IV. Provider business mailing address

1020 N 12TH ST DOWNTOWN HEALTH CENTER
MILWAUKEE WI
53233-1308
US

V. Phone/Fax

Practice location:
  • Phone: 414-277-8900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number21031
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: