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Individual

OLIVER JOHN MITHOEFER

Active
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Individual

OLIVER JOHN MITHOEFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL84280
SC
207R00000X
Internal Medicine Physician
Primary
V0479
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84280
SOUTH CAROLINA BOARD OF MEDICAL EXAMINERS
SC
01
—
LL84280
SOUTH CAROLINA BOARD OF MEDICAL EXAMINERS LIMITED LICENSE
SC
01
—
V0479
TEXAS MEDICAL BOARD
TX
Enumeration date
06/05/2020
Last updated
01/06/2025
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