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Individual

DR. AMBUJAKSHAN DILDEEP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
3737 SOUTHERN BLVD, SUITE 2000, KETTERING, OH 45429-1262
(937) 610-1915
(937) 610-1917
Mailing address
1 PRESTIGE PL, SUITE 550, MIAMISBURG, OH 45342-3794
(937) 752-2305
(937) 522-7513

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35122500
OH
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0094140
OH
Enumeration date
05/02/2009
Last updated
09/16/2014
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