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Organization
ALLIANCE PHYSICIAN INC
Active
Organization
ALLIANCE PHYSICIAN INC
Active
Parent organization
ALLIANCE PHYSICIAN INC
Other names
Grandview Medical Center OR Dept
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALLIANCE PHYSICIAN INC
Authorized official
DANIEL D HAIBACH (DIRECTOR BUSINESS DEVELPMENT)
(937) 558-3222
Entity
Organization
Contact information
Practice address
405 W GRAND AVE, OR DEPT, DAYTON, OH 45405-4720
(937) 723-3232
(937) 723-3854
Mailing address
2110 LEITER RD, MIAMISBURG, OH 45342-3660
(937) 384-4838
(937) 384-4845
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2712872
—
OH
Enumeration date
09/13/2011
Last updated
09/13/2011
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