Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 35078603 | OH |
Y | 207VE0102X | Reproductive Endocrinologist | MD 028781E | PA |
NPI | 1417953225 |
---|---|
Provider Name | Heinz O Osterholzer |
First Address | Danville, PA 17822-2920 |
Second Address | Danville, PA 17822-2920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 10/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000210803 | ANTHEM MEDICAID (01) | OH |
2209667 | (05) | OH |
4251439 | MI MEDICAID (01) | MI |
B37663 | (02) | OH |