| Midwest Dysphagia Consultants, Llc | |
|
5710 Wooster Pike Ste 102 Cincinnati OH 45227-4520 | |
| (281) 272-6277 | |
| (281) 272-6277 |
| Full Name | Midwest Dysphagia Consultants, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5710 Wooster Pike Ste 102, Cincinnati, Ohio |
| Authorized Official Name and Position | Ben Baumer (BOM) |
| Authorized Official Contact | 8052751834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Dysphagia Consultants, Llc 1717 Rotary Dr Humble TX 77338-5235 Ph: (281) 272-6277 | Midwest Dysphagia Consultants, Llc 5710 Wooster Pike Ste 102 Cincinnati OH 45227-4520 Ph: (281) 272-6277 |
| NPI Number | 1639404171 |
|---|---|
| Provider Enumeration Date | 10/15/2009 |
| Last Update Date | 03/26/2019 |
| Medicare PECOS PAC ID | 8820360795 |
|---|---|
| Medicare Enrollment ID | O20170828002434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639404171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Giavonne D Rondo Hillman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124083514 PECOS PAC ID: 8729050976 Enrollment ID: I20040809001327 |
| Provider Name | David F Box |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346219185 PECOS PAC ID: 7517032493 Enrollment ID: I20080813000119 |
| Provider Name | David Hall |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1811912116 PECOS PAC ID: 3173650629 Enrollment ID: I20100415000158 |
| Provider Name | Luis M Velasco |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093770992 PECOS PAC ID: 2466410634 Enrollment ID: I20110819000037 |
| Provider Name | Nathan B Baumer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811908619 PECOS PAC ID: 0547256760 Enrollment ID: I20170911002556 |
| Provider Name | Gregory L Smith |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1417032905 PECOS PAC ID: 2769408541 Enrollment ID: I20170911002905 |
| Provider Name | Ami E Rice |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194984245 PECOS PAC ID: 2567728041 Enrollment ID: I20171116001257 |
| Provider Name | Latricia Trena Willis Gillis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699934463 PECOS PAC ID: 5597830836 Enrollment ID: I20180123001303 |
| Provider Name | Mary Elizabeth Prentice |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700993581 PECOS PAC ID: 4183771884 Enrollment ID: I20180216001520 |
| Provider Name | Laura Cline |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326534264 PECOS PAC ID: 9133476245 Enrollment ID: I20180720000691 |
| Provider Name | Ronnie C. Wiedower |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548226970 PECOS PAC ID: 6103078233 Enrollment ID: I20181011001942 |
| Provider Name | Gillbert Daryl Hallman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013918952 PECOS PAC ID: 8527967785 Enrollment ID: I20181221000701 |
| Provider Name | Kevin Krembs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134209265 PECOS PAC ID: 0042230047 Enrollment ID: I20190501000067 |
| Provider Name | Alexei Arkadievich Krainev |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932586518 PECOS PAC ID: 4183916190 Enrollment ID: I20190930001658 |
| Provider Name | Elizabeth Prusak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255514386 PECOS PAC ID: 1153453352 Enrollment ID: I20200128001516 |
| Provider Name | Daniel Alexander Bonnin |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841795994 PECOS PAC ID: 9234506718 Enrollment ID: I20221114001436 |
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