Organization
MILL VALLEY PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES MICHAEL UNDERWOOD D.O. (PRESIDENT)
(937) 578-4210
Entity
Organization
Contact information
Practice address
1140 CHARLES LN, MARYSVILLE, OH 43040-9797
(937) 578-4210
Mailing address
200 BRADENTON AVE, DUBLIN, OH 43017-7515
(614) 793-1980
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34-007098
OH
Other
Enumeration date
09/14/2007
Last updated
09/14/2007
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