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General NPI Number Information
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NPI Number | 1609953892
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Entity Type | Individual
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Provider Name | MICHAEL THOMAS LAIRD M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 921 OAK PARK BLVD
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City | PISMO BEACH
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State | CA
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Zip | 93449-3264
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Country | US
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Telephone | 805-476-4949
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Fax | 808-473-3165
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Provider Business Mailing Address
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Address Line | 921 OAK PARK BLVD
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City | PISMO BEACH
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State | CA
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Zip | 93449-3264
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Country | US
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Telephone | 805-473-4949
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Fax | 808-473-3165
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G78037
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License Number State | CA
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