Healthcare Provider Details

I. General information

NPI: 1740984558
Provider Name (Legal Business Name): AUTUMN DAWN BIEBER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 FRIENDSVILLE RD STE 209
WOOSTER OH
44691-9601
US

IV. Provider business mailing address

3807 FRIENDSVILLE RD STE 209
WOOSTER OH
44691-9601
US

V. Phone/Fax

Practice location:
  • Phone: 330-345-1100
  • Fax:
Mailing address:
  • Phone: 330-345-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.156504
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: