Provider Demographics
NPI:1558313452
Name:HELMAN, LAURA LEE (DO)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:HELMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 LINCOLNWAY W
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-1709
Mailing Address - Country:US
Mailing Address - Phone:574-255-4733
Mailing Address - Fax:574-255-4464
Practice Address - Street 1:1207 LINCOLNWAY W
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544
Practice Address - Country:US
Practice Address - Phone:574-255-4733
Practice Address - Fax:574-255-4464
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002716A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0000003862OtherBCBS
IN200520670Medicaid
226110Medicare ID - Type Unspecified
IN200520670Medicaid