Healthcare Provider Details

I. General information

NPI: 1447993696
Provider Name (Legal Business Name): MICHAEL TENSMEYER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST STE 6257
DAYTON OH
45409-2939
US

IV. Provider business mailing address

30 E APPLE ST STE 6257
DAYTON OH
45409-2939
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-4200
  • Fax:
Mailing address:
  • Phone: 937-208-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number34.018545
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: