Provider Demographics
NPI:1801851837
Name:LAIRD, ROBERT H (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:LAIRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:76-6225 KUAKINI HWY
Mailing Address - Street 2:STE C-101
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-3212
Mailing Address - Country:US
Mailing Address - Phone:808-329-7067
Mailing Address - Fax:808-329-2404
Practice Address - Street 1:76-6225 KUAKINI HWY
Practice Address - Street 2:STE C-101
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3212
Practice Address - Country:US
Practice Address - Phone:808-329-7067
Practice Address - Fax:808-329-2404
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD2071208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03843301Medicaid