Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35128495 | OH |
NPI | 1043657067 |
---|---|
Provider Name | Ben Niver |
First Address | Cincinnati, OH 45212-1979 |
Second Address | Blue Ash, OH 45242-4710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2013 |
Last Update Date | 17/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CC2433 | RAILROAD MEDICARE (01) | OH |
H451560 | INDIVIDUAL PTAN (01) | OH |