Provider Demographics
NPI:1639556095
Name:STRIEBEL-WILLIAMS, LAURA (DO)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:STRIEBEL-WILLIAMS
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 1:2510 COMMONS BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3821
Mailing Address - Country:US
Mailing Address - Phone:937-490-0123
Mailing Address - Fax:937-306-1536
Practice Address - Street 1:2510 COMMONS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3821
Practice Address - Country:US
Practice Address - Phone:937-490-0123
Practice Address - Fax:937-306-1536
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.013455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0295223Medicaid