Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.123071 | OH |
Y | 2080P0204X | Pediatric Emergency Doctor | 35.123071 | OH |
NPI | 1033400387 |
---|---|
Provider Name | Kevin Michael Overmann |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2011 |
Last Update Date | 02/12/2019 |