Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | NO054737 | MI |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | NO054737 | MI |
NPI | 1518947977 |
---|---|
Provider Name | Neal Edward Obermyer |
First Address | Port Huron, MI 48060-3382 |
Second Address | Port Huron, MI 48060-3382 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 16/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040015414 | RRMCR (01) | MI |
0407411191 | BCBS OF MICHIGAN (01) | MI |
127760 | CARE CHOICES (01) | MI |
1912162005 | CIGNA (01) | MI |
4474473 | AETNA (01) | MI |
F77961 | (02) | MI |
F77961 | HAP (01) | MI |