Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 35-0475920 | OH |
NPI | 1023003415 |
---|---|
Provider Name | Emil Mitchel Opremcak |
First Address | Columbus, OH 43215-7310 |
Second Address | Columbus, OH 43215-7310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 25/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0708112 | (05) | OH |
180028608 | RAILROAD MEDICARE (01) | |
A83084 | (02) |