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NPI Code Detail

MEDICARE: ROBERT OLIVER

MEDICARE: ROBERT OLIVER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician34012772OH

General Provider Information

NPI Number : 1154717007
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT OLIVER
Provider Business Mailing Address
First Line : 6282 BLACKHEATH CIR
Second Line :
City : MASON
State : OH
Zip : 45040-4022
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1775 W LEXINGTON
Second Line : SUITE 100
City : CINCINNATI
State : OH
Zip : 45212-3589
Country : US
Telephone Number : 513-977-6750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2015
Last Update Date : 08/13/2017

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Directions to “ ROBERT OLIVER ” Practice Location

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