Basic Information
| Provider Information | |||||||||
| NPI: | 1649258617 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAIT | ||||||||
| FirstName: | MARCI | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4917 S CROATAN HWY STE 1C | ||||||||
| Address2: | |||||||||
| City: | NAGS HEAD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279598996 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524894682 | ||||||||
| FaxNumber: | 2527152007 | ||||||||
| Practice Location | |||||||||
| Address1: | 4917 S CROATAN HWY STE 1C | ||||||||
| Address2: | |||||||||
| City: | NAGS HEAD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279598996 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524894682 | ||||||||
| FaxNumber: | 2527152007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2006 | ||||||||
| LastUpdateDate: | 06/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 209643 | MA | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 2007-01728 | NC | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 0139611 | 01 | HEALTHY START | OTHER | 0139611 | 05 | MA | MEDICAID | 04 2472266 | 01 | THREE RIVERS | OTHER | 7956314 | 01 | AETNA US HEALTHCARE | OTHER | AA3713 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | J23431 | 01 | BLUE SHIELD HMO BLUE | OTHER | 04 2472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 60884 | 01 | FALLON COMMUNITY HEALTH P | OTHER | 784045 | 01 | MVP HEALTH CARE | OTHER | 10 00121 | 01 | EVERCARE | OTHER | 1496762 | 01 | CIGNA HEALTH PLAN | OTHER | 040016008 | 01 | RAILROAD MEDICARE | OTHER | A32301 | 01 | MEDICARE B | OTHER | J23431 | 01 | BLUE CARE ELECT | OTHER | J23431 | 01 | BLUE SHIELD INDEMNITY | OTHER | 042472266 | 01 | HEALTHCARE VALUE MANAGEME | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 1919737 | 01 | FIRST HEALTH | OTHER |