| Premier Gastroenterology, Inc. | |
|
1537 South Breiel Boulevard Middletown OH 45044-6703 | |
| (513) 425-8300 | |
| (513) 425-8301 |
| Full Name | Premier Gastroenterology, Inc. |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1537 South Breiel Boulevard, Middletown, Ohio |
| Authorized Official Name and Position | Dennis Min (PRESIDENT) |
| Authorized Official Contact | 5134258300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Gastroenterology, Inc. 1537 South Breiel Boulevard Middletown OH 45044-6703 Ph: (513) 425-8300 | Premier Gastroenterology, Inc. 1537 South Breiel Boulevard Middletown OH 45044-6703 Ph: (513) 425-8300 |
| NPI Number | 1013999424 |
|---|---|
| Provider Enumeration Date | 11/20/2005 |
| Last Update Date | 04/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013999424 | NPI | - | NPPES |
| 2460877 | Medicaid | OH | |
| 447788786-00 | Other | OH | OHIO BWC |
| 447788786002 | Other | OH | MEDICAL MUTUAL OF OHIO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 207RG0100X (Ohio) | Primary |
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