Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 35031878P | OH |
NPI | 1245226638 |
---|---|
Provider Name | Mr. Martin B Popp |
First Address | Cincinnati, OH 45219-2906 |
Second Address | Cincinnati, OH 45219-2906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 27/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0413163 | (05) | OH |
0921293 | (05) | OH |
100394580 | (05) | IN |
200100530A | (05) | IN |
64766744 | (05) | KY |
B96469 | (02) |