Individual
CHI TAI PETER LAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1015 OBRIE ST, ZWOLLE, LA 71486-2510
(318) 645-6161
(318) 798-4601
Mailing address
PO BOX 5313, SHREVEPORT, LA 71135-5313
(318) 798-4539
(318) 798-4601
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
023409
LA
207P00000X
Emergency Medicine Physician
MD.023409
LA
207Q00000X
Family Medicine Physician
Primary
023409
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1494909
—
LA
01
—
P00435402
RAILROAD MEDICARE NUMBER
LA
Enumeration date
03/21/2006
Last updated
08/23/2024
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