Provider Demographics
NPI:1033129937
Name:OFFENBERGER, JOHN BRETT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRETT
Last Name:OFFENBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 DELTA AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-1221
Mailing Address - Country:US
Mailing Address - Phone:513-321-9902
Mailing Address - Fax:513-533-8851
Practice Address - Street 1:820 DELTA AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226-1221
Practice Address - Country:US
Practice Address - Phone:513-321-9902
Practice Address - Fax:513-533-8851
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH578802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E76753Medicare UPIN
OH0681012Medicare ID - Type Unspecified