Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 35037240 | OH |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 35.037240 | OH |
NPI | 1922092519 |
---|---|
Provider Name | Dr. Beryl M Oser |
First Address | Columbus, OH 43212-1046 |
Second Address | Columbus, OH 43205-2207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 11/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A75722 | (02) |