Individual
DR. MARK OBERMYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036118405
IL
207R00000X
Internal Medicine Physician
Primary
51868
WI
208000000X
Pediatrics Physician
036118405
IL
208000000X
Pediatrics Physician
51868
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669634820
—
WI
Enumeration date
06/30/2008
Last updated
07/10/2012
Update your record
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