Provider Demographics
NPI:1760424006
Name:DEEHR, DAVID W (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:DEEHR
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 1:21 MILAN MANOR DR
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:OH
Mailing Address - Zip Code:44846-9601
Mailing Address - Country:US
Mailing Address - Phone:419-334-6624
Mailing Address - Fax:419-334-6602
Practice Address - Street 1:715 S TAFT AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3200
Practice Address - Country:US
Practice Address - Phone:419-334-6624
Practice Address - Fax:419-334-6602
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002057207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0248977Medicaid
OHDE0398932Medicare ID - Type Unspecified
OH0248977Medicaid