Healthcare Provider Details

I. General information

NPI: 1487607511
Provider Name (Legal Business Name): STRIEBEL FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7391 BRANDT PIKE STE A
HUBER HEIGHTS OH
45424-3200
US

IV. Provider business mailing address

7391 BRANDT PIKE SUITE A
HUBER HEIGHTS OH
45424-3233
US

V. Phone/Fax

Practice location:
  • Phone: 937-236-0373
  • Fax: 937-236-2737
Mailing address:
  • Phone: 937-236-0373
  • Fax: 737-236-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK H STRIEBEL
Title or Position: PHYSICIAN
Credential: DO
Phone: 937-236-0373