Provider Demographics
NPI:1407883630
Name:CHAMBERS KERSH, LAURA SINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:SINDA
Last Name:CHAMBERS KERSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 N FAIRFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2783
Mailing Address - Country:US
Mailing Address - Phone:937-558-3900
Mailing Address - Fax:937-558-3999
Practice Address - Street 1:2145 N FAIRFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431
Practice Address - Country:US
Practice Address - Phone:937-558-3900
Practice Address - Fax:937-558-3999
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.136447207Q00000X
MN46690207Q00000X
TXP4429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN106789OtherUCARE
AZ155931Medicaid
MN642687500Medicaid
OH0365076Medicaid
NM97539775Medicaid
MN1043187OtherPREFERRED ONE
CO39634566Medicaid
MN500T6CHOtherBCBS
MN66-08090OtherMEDICA CHOICE & PRIMARY
MN106789OtherUCARE
I18795Medicare UPIN
MN080013543Medicare ID - Type UnspecifiedMN MEDICARE