Individual
CHARLES OPPERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1470 N BROADWAY ST STE 130, LEBANON, OH 45036-1762
(513) 696-1280
(513) 228-1134
Mailing address
1 PRESTIGE PL, MIAMISBURG, OH 45342-3794
(937) 752-2305
(937) 522-7513
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35124341
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122201
—
OH
Enumeration date
04/04/2012
Last updated
12/04/2017
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