Individual
DR. DAVID A. NIEDERKOHR
Active
Individual
DR. DAVID A. NIEDERKOHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3260T1062
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000117913
ANTHEM BC/BS
—
01
—
0005353619
AETNA
—
05
—
0349813
—
OH
01
—
17042
SPECTERA
OH
01
—
311001012003
MEDICAL MUTUAL
OH
01
—
3230
DAVIS VISION
—
01
—
OH1062
EYEMED
OH
Enumeration date
11/01/2006
Last updated
05/22/2012
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