Provider Demographics
NPI:1801878715
Name:MUSSER, LAURA ANDERSON (DO)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANDERSON
Last Name:MUSSER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4135 BOARDMAN CANFIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9803
Mailing Address - Country:US
Mailing Address - Phone:330-286-5330
Mailing Address - Fax:330-286-5396
Practice Address - Street 1:22 MCCLURG RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6736
Practice Address - Country:US
Practice Address - Phone:330-965-9400
Practice Address - Fax:330-330-8158
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2019-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34 007657M207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2408639Medicaid
OH4066922Medicare ID - Type Unspecified
OH2408639Medicaid