Organization
VISIONARY HEALTH BY M2C
Active
Other names
Maranatha Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA MONICA CORRADINE M.D. (OWNER)
(937) 271-3250
Entity
Organization
Contact information
Practice address
5900 N MAIN ST, DAYTON, OH 45415-3150
(937) 271-3250
Mailing address
5900 N MAIN ST, DAYTON, OH 45415-3150
(937) 271-3250
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2052380
—
OH
01
—
CO4083015
MEDICARE
OH
Enumeration date
06/21/2018
Last updated
06/21/2018
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