Provider Demographics
NPI:1548605264
Name:OLTMANN, MEGAN LYNN (DPM)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:LYNN
Last Name:OLTMANN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33790 BAINBRIDGE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2982
Mailing Address - Country:US
Mailing Address - Phone:440-903-1041
Mailing Address - Fax:440-600-2327
Practice Address - Street 1:33790 BAINBRIDGE RD STE 201
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2982
Practice Address - Country:US
Practice Address - Phone:440-903-1041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003770213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0195835Medicaid
OH36.003770OtherOHIO ELICENSE OHIO PROFESSIONAL LICENSURE