Provider Demographics
NPI:1710923818
Name:LAING, CHARMAINE P (MD)
Entity Type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:P
Last Name:LAING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7868 NW 17TH PL
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-0913
Mailing Address - Country:US
Mailing Address - Phone:954-987-6159
Mailing Address - Fax:954-987-6161
Practice Address - Street 1:7868 NW 17TH PL
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-0913
Practice Address - Country:US
Practice Address - Phone:954-987-6159
Practice Address - Fax:954-987-6161
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME81496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58878YMedicare PIN
H50518Medicare UPIN