| North Dayton Internal Medicine | |
|
80 E Woodbury Dr Suite B Dayton OH 45415-2800 | |
| (937) 278-2303 | |
| (937) 278-2662 |
| Full Name | North Dayton Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 80 E Woodbury Dr, Dayton, Ohio |
| Authorized Official Name and Position | Kenneth Prunier (PRESIDENT/CEO) |
| Authorized Official Contact | 9374998213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Dayton Internal Medicine 80 E Woodbury Dr Suite B Dayton OH 45415-2800 Ph: (937) 278-2303 | North Dayton Internal Medicine 80 E Woodbury Dr Suite B Dayton OH 45415-2800 Ph: (937) 278-2303 |
| NPI Number | 1699022319 |
|---|---|
| Provider Enumeration Date | 08/13/2012 |
| Last Update Date | 01/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699022319 | NPI | - | NPPES |
| 0072145 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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