Organization
PREMIER GASTROENTEROLOGY, INC.
Active
Other names
Premier Gastroenterology, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS MIN D.O. (PRESIDENT)
(513) 425-8300
Entity
Organization
Contact information
Practice address
1537 SOUTH BREIEL BOULEVARD, MIDDLETOWN, OH 45044-6703
(513) 425-8300
(513) 425-8301
Mailing address
1537 SOUTH BREIEL BOULEVARD, MIDDLETOWN, OH 45044-6703
(513) 425-8300
(513) 425-8301
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
207RG0100X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2460877
—
OH
01
—
447788786-00
OHIO BWC
OH
01
—
447788786002
MEDICAL MUTUAL OF OHIO
OH
Enumeration date
11/20/2005
Last updated
04/25/2014
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