Provider Demographics
NPI:1972694016
Name:LEBEL, LAURA W (MD)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:W
Last Name:LEBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:LAUREL
Other - Middle Name:
Other - Last Name:WIELAND-LEBEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:801 ROPER CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615
Mailing Address - Country:US
Mailing Address - Phone:864-343-3553
Mailing Address - Fax:864-516-1036
Practice Address - Street 1:801 ROPER CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615
Practice Address - Country:US
Practice Address - Phone:864-343-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23313207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCH63154Medicare UPIN
SC8157Medicare ID - Type UnspecifiedMEDICARE