Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35.120784 | OH |
N | 111NI0900X | Internist | 35.120784 | OH |
Y | 207RH0003X | Hematology & Oncology | 35.120784 | OH |
NPI | 1013231562 |
---|---|
Provider Name | Drew Randall Oostra |
First Address | Toledo, OH 43606-5102 |
Second Address | Toledo, OH 43606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2010 |
Last Update Date | 02/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0084817 | (05) | OH |