Provider Demographics
NPI:1154927697
Name:OBERMEYER, DEVIN EDWARD
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:EDWARD
Last Name:OBERMEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9340 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-3709
Mailing Address - Country:US
Mailing Address - Phone:513-379-8449
Mailing Address - Fax:
Practice Address - Street 1:9340 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3709
Practice Address - Country:US
Practice Address - Phone:513-379-8449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program