Individual
KALEB T DEAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
225 STOCKSDALE DR, MARYSVILLE, OH 43040-5511
(937) 644-2070
(937) 644-0105
Mailing address
225 STOCKSDALE DR, MARYSVILLE, OH 43040-5511
(937) 644-2070
(937) 644-0105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.015437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0468419
—
OH
Enumeration date
05/08/2019
Last updated
03/24/2022
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