Provider Demographics
NPI:1073651014
Name:NEIMAN, DAVE F JR
Entity Type:Individual
Prefix:MR
First Name:DAVE
Middle Name:F
Last Name:NEIMAN
Suffix:JR
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 1:487 E STAFFORD AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3179
Mailing Address - Country:US
Mailing Address - Phone:614-256-3629
Mailing Address - Fax:
Practice Address - Street 1:487 E STAFFORD AVE APT B
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3179
Practice Address - Country:US
Practice Address - Phone:614-256-3629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor