Provider Demographics
NPI:1437198769
Name:KAISER SUND, LAURIE DEANN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:DEANN
Last Name:KAISER SUND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 SAINT PETER ST
Mailing Address - Street 2:GALLERY TOWERS, SUTIE 200
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1001
Mailing Address - Country:US
Mailing Address - Phone:651-326-3600
Mailing Address - Fax:651-326-3626
Practice Address - Street 1:514 SAINT PETER ST
Practice Address - Street 2:GALLERY TOWERS, SUTIE 200
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1001
Practice Address - Country:US
Practice Address - Phone:651-326-3600
Practice Address - Fax:651-326-3626
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40720207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1066910OtherAMERICA'S PPO
MN244291019819OtherPREFERRED ONE
MNHP27083OtherHEALTHPARTNERS
MNP00207478OtherRR MEDICARE
MN289K7SUOtherBLUE CROSS BLUE SHIELD
MN0118264OtherSELECT CARE
MNMEDICAOther0118264
MN289K7SUOtherBLUE CROSS BLUE SHIELD