Healthcare Provider Details

I. General information

NPI: 1235056805
Provider Name (Legal Business Name): ROBERT OBERMEIER HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 KUNLUN DR
COLUMBIA MO
65203-8011
US

IV. Provider business mailing address

3305 KUNLUN DR
COLUMBIA MO
65203-8011
US

V. Phone/Fax

Practice location:
  • Phone: 573-355-0685
  • Fax:
Mailing address:
  • Phone: 573-355-0685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number001282
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: