Provider Demographics
NPI:1164505822
Name:FOLIANO, LAURA (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FOLIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:FOLIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1010 WOODMAN DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45432-1400
Mailing Address - Country:US
Mailing Address - Phone:937-252-2000
Mailing Address - Fax:937-252-1224
Practice Address - Street 1:1010 WOODMAN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432-1400
Practice Address - Country:US
Practice Address - Phone:937-252-2000
Practice Address - Fax:937-252-1224
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0892806Medicaid
OHP00190593OtherRAILROAD MEDICARE
OHP00190593OtherRAILROAD MEDICARE
OHF10340Medicare UPIN
OHH063660Medicare PIN