|
| |
|
3038 Olive Rd Trotwood OH 45426-2640 | |
| (937) 208-7050 | |
| (937) 208-7031 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 3038 Olive Rd, Trotwood, Ohio |
| Authorized Official Name and Position | Kenneth Prunier (PRESIDENT/CEO) |
| Authorized Official Contact | 9372088213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3038 Olive Rd Trotwood OH 45426-2640 Ph: (937) 208-7050 | 3038 Olive Rd Trotwood OH 45426-2640 Ph: (937) 208-7050 |
| NPI Number | 1841243862 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 11/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841243862 | NPI | - | NPPES |
| 0823961 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Margaret A Edwards Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5308 Weddington Dr, Trotwood, OH 45426 Phone: 937-248-1825 | |