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29 Kyle Dr Cedarville OH 45314-9580 | |
(937) 766-2611 | |
(937) 766-5558 |
Full Name | |
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Speciality | Family Medicine |
Location | 29 Kyle Dr, Cedarville, Ohio |
Authorized Official Name and Position | Daniel D Haibach (DIRECTOR BUSINESS DEVELOPMENT) |
Authorized Official Contact | 9375583222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2110 Leiter Rd Miamisburg OH 45342-3660 Ph: (937) 384-4838 | 29 Kyle Dr Cedarville OH 45314-9580 Ph: (937) 766-2611 |
NPI Number | 1760768089 |
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Provider Enumeration Date | 11/01/2011 |
Last Update Date | 11/01/2011 |
Identifier | Type | State | Issuer |
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1760768089 | NPI | - | NPPES |
2639630 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |