| Sycamore Primary Care Group | |
|
2115 Leiter Rd Miamisburg OH 45342-3659 | |
| (937) 384-6842 | |
| (937) 384-6939 |
| Full Name | Sycamore Primary Care Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 2115 Leiter Rd, Miamisburg, Ohio |
| Authorized Official Name and Position | Timothy Y Ko (CFO) |
| Authorized Official Contact | 9375583208 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sycamore Primary Care Group 10050 Innovation Dr Suite 200 Miamisburg OH 45342-4931 Ph: (937) 558-3208 | Sycamore Primary Care Group 2115 Leiter Rd Miamisburg OH 45342-3659 Ph: (937) 384-6842 |
| NPI Number | 1871548164 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 10/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871548164 | NPI | - | NPPES |
| 0227829 | Medicaid | OH | |
| SY9283031 | Other | OH | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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