Individual
DR. LAURA ELIZABETH THIEME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2705 N LEBANON ST STE 415, LEBANON, IN 46052-8621
(765) 485-8900
(765) 485-8909
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01073740A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201099890
—
IN
Enumeration date
05/24/2011
Last updated
10/11/2023
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