Individual
DR. LAURA LEE KONCZAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-1000
Mailing address
11100 EUCLID AVE, LAKESIDE STE 1500, CLEVELAND, OH 44106
(216) 844-3936
(216) 844-7497
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
35085739
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022542000001
—
PA
05
—
2839138
—
OH
01
—
465081
WELLCARE
OH
01
—
755709
BUCKEYE
OH
Enumeration date
06/13/2007
Last updated
01/19/2021
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