Provider Demographics
NPI:1720085186
Name:OVERHAGE, JOSEPH MARCUS (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARCUS
Last Name:OVERHAGE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 S 975 E
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-9554
Mailing Address - Country:US
Mailing Address - Phone:317-873-9287
Mailing Address - Fax:317-873-9287
Practice Address - Street 1:4540 S 975 E
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-9554
Practice Address - Country:US
Practice Address - Phone:317-873-9287
Practice Address - Fax:317-873-9287
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038698A207R00000X, 2083C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E46668Medicare UPIN