Individual
DAVID J NEIDHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 W MARKET ST, LIMA, OH 45805-2768
(419) 229-4747
(419) 224-3348
Mailing address
915 W MARKET ST, LIMA, OH 45805-2768
(419) 229-4747
(419) 224-3348
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35055419
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000317842
ANTHEM/BCBS
OH
01
—
010024599
MEDICARE RR
OH
05
—
0681785
—
OH
01
—
P00072000
MEDICARE RAILROAD
OH
Enumeration date
05/16/2006
Last updated
06/04/2008
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