Organization
DAYTON CHILDREN'S HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS E. BERGMAN (VP/CHIEF FINANCIAL OFFICER/ACCOUNTI)
(937) 641-3338
Entity
Organization
Contact information
Practice address
3333 WEST TECH ROAD, MIAMISBURG, OH 45342
(937) 641-5725
(937) 641-6115
Mailing address
ONE CHILDREN'S PLAZA, DAYTON, OH 45404-1898
(937) 641-3000
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0465509
—
OH
01
—
363306
MEDICARE
OH
Enumeration date
10/05/2009
Last updated
05/10/2019
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