Provider Demographics
NPI:1396236980
Name:GAWRYS-STRAND, ELIZABETH RUTHANNE (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RUTHANNE
Last Name:GAWRYS-STRAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:RUTHANNE
Other - Last Name:BRUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 S ALEX RD
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-4471
Mailing Address - Country:US
Mailing Address - Phone:937-247-0304
Mailing Address - Fax:
Practice Address - Street 1:5 S ALEX RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-4471
Practice Address - Country:US
Practice Address - Phone:937-247-0304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-20
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.145758208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0297332Medicaid