Michael J Laroque, MD

Individual provider Active NPI Family Medicine Physician · Ogema, MN

NPI 1063528883 · NPPES record last updated Feb 1, 2012

Key facts

NPI
1063528883
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
7952 (ND)
Practice address
40520 County Highway 34
Ogema, MN 56569-9612
Phone
(218) 983-4300
Fax
(218) 983-6394
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7952 ND Yes

Addresses

Primary practice location

40520 County Highway 34
Ogema, MN 56569-9612

Mailing address

40520 County Highway 34
Ogema, MN 56569-9612
Phone (218) 983-4300

Other identifiers

IdentifierTypeStateIssuer
MD2854MedicaidAK

Other providers in Ogema, MN

All providers in Ogema, MN · Family Medicine Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.