Overdahl, Michael C
Overdahl, Michael C is an individual health care provider with primary practice located at 11104 Parkview Circle Dr Suite 410, Fort Wayne IN 46845-1672. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Overdahl, Michael C can be contacted via phone (260) 266-5260.Contact Information
Primary practice address
11104 Parkview Circle Dr Suite 410
Fort Wayne IN 46845-1672
Phone: (260) 266-5260
Fax: (260) 266-5269
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 01042341 | Indiana |
Profile Details
| NPI number | 1316990112 |
|---|---|
| LBN Legal business name | Overdahl, Michael C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2006 |
| Last updated | Oct 7th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316990112 | NPPES |
| Indiana | Other | P00685770 | RR MEDICARE |
| Indiana | MEDICAID | 200015210 | RR MEDICARE |
| Indiana | Other | 000000576774 | RR MEDICARE |
| Indiana | Other | 000000670288 | RR MEDICARE |
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