Healthcare Provider Details

I. General information

NPI: 1487616751
Provider Name (Legal Business Name): EDWARD JOSEPH HEMEYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 04/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N SANDUSKY ST SUITE A
BELLEVUE OH
44811-1180
US

IV. Provider business mailing address

PO BOX 378
SANDUSKY OH
44871-0378
US

V. Phone/Fax

Practice location:
  • Phone: 419-483-6267
  • Fax: 419-483-1614
Mailing address:
  • Phone: 419-609-1112
  • Fax: 419-609-1123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-059687
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35059687
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: