Healthcare Provider Details

I. General information

NPI: 1417921958
Provider Name (Legal Business Name): MARK D OXMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 WASHINGTON VILLAGE DR SUITE 230
DAYTON OH
45459
US

IV. Provider business mailing address

7700 WASHINGTON VILLAGE DR SUITE 220
DAYTON OH
45459
US

V. Phone/Fax

Practice location:
  • Phone: 937-438-3132
  • Fax: 937-438-8707
Mailing address:
  • Phone: 937-438-0099
  • Fax: 937-438-0902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number34004120
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: