Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2005021465 | MO |
Y | 2080P0205X | Pediatric Endocrinologist | 2005021465 | MO |
NPI | 1407862485 |
---|---|
Provider Name | Dr. John Michael Oberlin |
First Address | San Antonio, TX 78258-4308 |
Second Address | Fort Sam Houston, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 11/12/2014 |