Organization
MVHE, INC
Active
Other names
South Dayton Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH PRUNIER (CEO/PRESIDENT)
(937) 208-8213
Entity
Organization
Contact information
Practice address
6611 CLYO RD, SUITE C, CENTERVILLE, OH 45459-2786
(937) 208-8288
(937) 208-8286
Mailing address
6611 CLYO RD, SUITE C, CENTERVILLE, OH 45459-2786
(937) 208-8288
(937) 208-8286
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2387279
—
OH
Enumeration date
05/24/2006
Last updated
08/22/2020
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