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NPI Code Detail

MEDICARE: MR. ROBERT L NEIDICH MD

MEDICARE: MR. ROBERT L NEIDICH MD
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
1207RG0100XGastroenterology Physician35068286OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568433910
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT L NEIDICH MD
Provider Business Mailing Address
First Line : 10 RAVINE CT
Second Line :
City : LIMA
State : OH
Zip : 45805-4000
Country : US
Telephone Number : 419-999-1088
Fax Number : 419-222-6007
Provider Business Practice Location Address
First Line : 2793 SHAWNEE RD
Second Line :
City : LIMA
State : OH
Zip : 45806-1444
Country : US
Telephone Number : 419-227-8209
Fax Number : 419-222-6007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 10/09/2008

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