MEDICARE: DR. ERIN LEIGH PERKEY NIENABER DO

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
1	208000000X	Pediatrics Physician	34010047	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000000767286	OTHER	OH	ANTHEM
2	34.010047	OTHER	OH	MEDICAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700028362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIN LEIGH PERKEY NIENABER DO

Provider Business Mailing Address
First Line	:	PO BOX 933432
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0039
Country	:	US
Telephone Number	:	937-641-5072
Fax Number	:	937-641-6129

Provider Business Practice Location Address
First Line	:	1425 N FAIRFIELD RD STE 120
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45432-2674
Country	:	US
Telephone Number	:	937-320-3888
Fax Number	:	937-320-3848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2009
Last Update Date	:	10/04/2023

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