Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 4301086032 | MI |
NPI | 1073714457 |
---|---|
Provider Name | Dr. Mark Hoeprich |
First Address | Kettering, OH 45429-1226 |
Second Address | Kettering, OH 45429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0084972 | (05) | OH |