Provider Demographics
NPI:1457335358
Name:NEIGER, DAVID R (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:NEIGER
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 1:770 JASONWAY AVE
Mailing Address - Street 2:SUITE G-2
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-4333
Mailing Address - Country:US
Mailing Address - Phone:614-459-3687
Mailing Address - Fax:614-459-4675
Practice Address - Street 1:770 JASONWAY AVE
Practice Address - Street 2:SUITE G-2
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-4333
Practice Address - Country:US
Practice Address - Phone:614-459-3687
Practice Address - Fax:614-459-4675
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-7588207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0700674Medicaid
OH0887842Medicare PIN
OHA16139Medicare UPIN