Provider Demographics
NPI:1568606093
Name:NIEMEYER, ALISON RENEE (DPM)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:RENEE
Last Name:NIEMEYER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 WEST HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2725
Mailing Address - Country:US
Mailing Address - Phone:419-225-2726
Mailing Address - Fax:419-228-9909
Practice Address - Street 1:1138 WEST HIGH STREET
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2725
Practice Address - Country:US
Practice Address - Phone:419-225-2726
Practice Address - Fax:419-228-9909
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH59.000217213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2348856Medicaid
OHCB6624OtherRAILROAD MEDICARE
OH2348856Medicaid
OH5374990001Medicare NSC
OHCB6624OtherRAILROAD MEDICARE