Provider Demographics
NPI:1548478720
Name:WHARRY, LAURA ISABEL (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ISABEL
Last Name:WHARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:ISABEL
Other - Last Name:EICHHORN-WHARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2109 HUGHES DR
Mailing Address - Street 2:CONRAD JOBST TOWER, SUITE 220
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3856
Mailing Address - Country:US
Mailing Address - Phone:419-291-5150
Mailing Address - Fax:419-479-6173
Practice Address - Street 1:2109 HUGHES DR
Practice Address - Street 2:CONRAD JOBST TOWER, SUITE 220
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3856
Practice Address - Country:US
Practice Address - Phone:419-291-5150
Practice Address - Fax:419-479-6173
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087646208600000X
PAMD444725208600000X
OH35.121359208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery