Provider Demographics
NPI:1265572580
Name:PLEIMAN, MICHELLE R (OD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:R
Last Name:PLEIMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55 THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-8678
Mailing Address - Country:US
Mailing Address - Phone:937-475-0397
Mailing Address - Fax:934-435-4668
Practice Address - Street 1:2300 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3722
Practice Address - Country:US
Practice Address - Phone:937-475-0397
Practice Address - Fax:937-435-4668
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH-4869152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist