Organization
CARO PEDIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY L GREEN (OFFICE MANAGER)
(937) 275-8559
Entity
Organization
Contact information
Practice address
1435 SHOUP MILL RD, DAYTON, OH 45414-3978
(937) 275-3488
(937) 275-3371
Mailing address
1435 SHOUP MILL RD, DAYTON, OH 45414-3978
(937) 275-3488
(937) 275-3371
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34-002567
OH
208000000X
Pediatrics Physician
35-056515-C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0535326
—
OH
05
—
0696180
—
OH
Enumeration date
12/29/2011
Last updated
12/29/2011
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