| Charles D Hanshaw Do Inc | |
|
8940 Kingsridge Dr Suite 103 Dayton OH 45458-1632 | |
| (937) 439-7430 | |
| (937) 439-7446 |
| Full Name | Charles D Hanshaw Do Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8940 Kingsridge Dr, Dayton, Ohio |
| Authorized Official Name and Position | Charles D Hanshaw (PRESIDENT) |
| Authorized Official Contact | 9374397430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles D Hanshaw Do Inc 8940 Kingsridge Dr Suite 103 Dayton OH 45458-1632 Ph: (937) 439-7430 | Charles D Hanshaw Do Inc 8940 Kingsridge Dr Suite 103 Dayton OH 45458-1632 Ph: (937) 439-7430 |
| NPI Number | 1063692341 |
|---|---|
| Provider Enumeration Date | 11/05/2007 |
| Last Update Date | 06/30/2009 |
| Medicare PECOS PAC ID | 5991738494 |
|---|---|
| Medicare Enrollment ID | O20050915000195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063692341 | NPI | - | NPPES |
| 0734245 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 009141 (Ohio) | Secondary |
| 207R00000X | Internal Medicine | 34003234H (Ohio) | Primary |
| Provider Name | Aaron Patrick Hanshaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831310770 PECOS PAC ID: 1355493172 Enrollment ID: I20090708000720 |
| Provider Name | Charles Hanshaw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871523209 PECOS PAC ID: 1254364755 Enrollment ID: I20100225000590 |
| Provider Name | Karen Ann Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831717420 PECOS PAC ID: 0042630121 Enrollment ID: I20201009002342 |
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