Provider Demographics
NPI:1487607511
Name:STRIEBEL FAMILY PRACTICE
Entity type:Organization
Organization Name:STRIEBEL FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:STRIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-236-0373
Mailing Address - Street 1:7391 BRANDT PIKE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3233
Mailing Address - Country:US
Mailing Address - Phone:937-236-0373
Mailing Address - Fax:737-236-2737
Practice Address - Street 1:7391 BRANDT PIKE
Practice Address - Street 2:STE A
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3200
Practice Address - Country:US
Practice Address - Phone:937-236-0373
Practice Address - Fax:937-236-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHST9324811Medicare PIN