Individual
MARY BRIGID CHITWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9000 NORTH MAIN STREET, SUITE 332, DAYTON, OH 45415-1185
(937) 832-7337
(937) 832-4817
Mailing address
9000 NORTH MAIN STREET, SUITE 332, DAYTON, OH 45415-1185
(937) 832-7337
(937) 832-4817
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
35063336
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000037309
BLUE CROSS BLUE SHIELD
—
01
—
0635731
AETNA
—
01
—
0912641
BUR CHILDREN W MED HANDIC
—
01
—
1220312
UNITED HEALTHCARE
—
01
—
311627276036
CARESOURCE
—
Enumeration date
10/03/2006
Last updated
07/08/2007
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