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Individual
DENNIS RICHARD NIESS
Active
Individual
DENNIS RICHARD NIESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12719
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0530027
—
OH
01
—
12719D
HEALTH PLAN OF UPPER OH V
—
01
—
55068028400
OHIO BWC
OH
Enumeration date
08/09/2005
Last updated
07/08/2007
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