Organization
DAYTON GASTROENTEROLOGY LLC
Active
Other names
Gastroenterology and Hepatology Specialists, Digestive Disease Consultants, GREAT LAKES GASTROENTEROLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MATERNA (DIRECTOR, CREDENTIALING)
(901) 377-8219
Entity
Organization
Contact information
Practice address
75 SYLVANIA DR, DAYTON, OH 45440-3237
(937) 320-5050
(937) 320-5060
Mailing address
ONE GI CREDENTIALING DEPARTMENT, PO BOX 381468, GERMANTOWN, TN 38183
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3059523
—
OH
Enumeration date
04/18/2007
Last updated
02/03/2026
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