Provider Demographics
NPI:1033328919
Name:NIEMEIER, LEO ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:ANTHONY
Last Name:NIEMEIER
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:PO BOX 20452
Mailing Address - Street 2:CORPATH CRED
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-257-9010
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:3535 OLENTANGY RIVER RD
Practice Address - Street 2:RMH PATHOLOGY DEPT - CORPATH
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-566-4945
Practice Address - Fax:614-263-1056
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35095314207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHUSE SSN-00OtherOHIO BWC
OH3046868Medicaid
OHP00854675OtherRR MCR
OHUSE SSN-00OtherOHIO BWC