Provider Demographics
NPI:1376617613
Name:THOMAS R NEUMAN MD LLC
Entity Type:Organization
Organization Name:THOMAS R NEUMAN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-856-2957
Mailing Address - Street 1:349 NILES CORTLAND RD NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1976
Mailing Address - Country:US
Mailing Address - Phone:330-856-2957
Mailing Address - Fax:330-856-1615
Practice Address - Street 1:349 NILES CORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1976
Practice Address - Country:US
Practice Address - Phone:330-856-2957
Practice Address - Fax:330-856-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070416174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000563561OtherANTHEM
OH292688705001OtherMEDICAL MUTUAL OF OHIO
PA0001341761OtherHIGHMARK BC/BS
1063413961OtherNPI
000000211855OtherANTHEM
OH2711202Medicaid
OH659868OtherAETNA
000000563291OtherANTHEM
OH0243347Medicaid
1851474498OtherNPI
1922196237OtherNPI
OH2808840Medicaid
P00161841OtherRAILROAD MEDICARE
1376617613OtherNPI
000000563291OtherANTHEM
1063413961OtherNPI
OH=========-002OtherMEDICAL MUTUAL OF OHIO
OH=========OtherFEIN
1922196237OtherNPI
OH292688705001OtherMEDICAL MUTUAL OF OHIO
OH0243347Medicaid