Provider Demographics
NPI:1417921958
Name:OXMAN, MARK D (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:OXMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 WASHINGTON VILLAGE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459
Mailing Address - Country:US
Mailing Address - Phone:937-438-0099
Mailing Address - Fax:937-438-0902
Practice Address - Street 1:7700 WASHINGTON VILLAGE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459
Practice Address - Country:US
Practice Address - Phone:937-438-3132
Practice Address - Fax:937-438-8707
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004120207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0908816Medicaid
OHH248600Medicare PIN
OHOX0689982Medicare PIN
OHOX0689983Medicare PIN
OHE84213Medicare UPIN
OH0908816Medicaid
OHOX0689986Medicare PIN
OHOX7317771Medicare PIN