Individual
DR. LAUREL A TAIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
MO00556
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02358739
—
MS
01
—
12934038
BLUE CROSS BLUE SHIELD
MO
01
—
480005007
RAILROAD MEDICARE
MO
Enumeration date
07/21/2006
Last updated
02/10/2022
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