Provider Demographics
NPI:1780664979
Name:OBERMAN, JAMES PHILLIP (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILLIP
Last Name:OBERMAN
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 1:19900 BRIARLEY HALL DR
Mailing Address - Street 2:
Mailing Address - City:POOLESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20837-2415
Mailing Address - Country:US
Mailing Address - Phone:904-315-7971
Mailing Address - Fax:
Practice Address - Street 1:501 W 7TH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4586
Practice Address - Country:US
Practice Address - Phone:240-575-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056078207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology