Provider Demographics
NPI:1437167814
Name:NEIMAN, LEON (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:NEIMAN
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 1:3500 W MARKET ST STE 3
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2663
Mailing Address - Country:US
Mailing Address - Phone:330-535-3101
Mailing Address - Fax:330-535-2411
Practice Address - Street 1:3500 W MARKET ST STE 3
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-2663
Practice Address - Country:US
Practice Address - Phone:330-535-3101
Practice Address - Fax:330-535-2411
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35023595207Y00000X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3139017Medicaid
OH0009270Medicaid
NE0119491Medicare ID - Type Unspecified