Provider Demographics
NPI:1417177403
Name:NIEMEYER, ERIC MORGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MORGAN
Last Name:NIEMEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3805 EDWARDS RD STE 360
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1934
Mailing Address - Country:US
Mailing Address - Phone:513-871-7848
Mailing Address - Fax:513-871-3278
Practice Address - Street 1:3805 EDWARDS RD STE 360
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1934
Practice Address - Country:US
Practice Address - Phone:513-871-7848
Practice Address - Fax:513-871-3278
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.093735207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2980636Medicaid
KY7100100510Medicaid
OH2980636Medicaid