Healthcare Provider Details

I. General information

NPI: 1861496788
Provider Name (Legal Business Name): WILLIAM J NIEMES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 RAY NORRISH DR # 2
CINCINNATI OH
45246-1520
US

IV. Provider business mailing address

422 RAY NORRISH DR # 2
CINCINNATI OH
45246-1520
US

V. Phone/Fax

Practice location:
  • Phone: 513-671-0799
  • Fax: 513-671-0845
Mailing address:
  • Phone: 513-671-0799
  • Fax: 513-671-0845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35.043245
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: