Basic Information
| Provider Information | |||||||||
| NPI: | 1568409696 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RINGLEIN | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 LONG RAPIDS RD | ||||||||
| Address2: | |||||||||
| City: | ALPENA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497071315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9893542142 | ||||||||
| FaxNumber: | 9893548600 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 LONG RAPIDS RD | ||||||||
| Address2: | |||||||||
| City: | ALPENA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497071315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9893542142 | ||||||||
| FaxNumber: | 9893548600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 02/02/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | LR011850 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | BR3914163 | 01 | MI | DEA | OTHER | 3181115 | 05 | MI | MEDICAID | 3811124 | 05 | MI | MEDICAID | 4892917 | 05 | MI | MEDICAID | 0F06016 | 01 | MI | MEDICARE BILL PAY TO | OTHER | 1568409696 | 01 | MI | NPI | OTHER | 4446609 | 05 | MI | MEDICAID |