Healthcare Provider Details

I. General information

NPI: 1518947977
Provider Name (Legal Business Name): NEAL EDWARD OBERMYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 SPARTAN DRIVE
FORT GRATIOT MI
48059
US

IV. Provider business mailing address

3838 SPARTAN DRIVE
FORT GRATIOT MI
48059
US

V. Phone/Fax

Practice location:
  • Phone: 810-434-6542
  • Fax: 810-982-0716
Mailing address:
  • Phone: 810-434-6542
  • Fax: 810-982-0716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberNO054737
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberNO054737
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberNO054737
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: