Individual
MICHAEL C OVERDAHL
Active
Individual
MICHAEL C OVERDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
01042341
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000576774
ANTHEM
IN
01
—
000000670288
ANTHEM
IN
05
—
200015210
—
IN
01
—
P00685770
RR MEDICARE
IN
Enumeration date
05/19/2006
Last updated
10/07/2022
Update your record
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