Individual
DAVID J ETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3359 KEMP RD, STE. 200, BEAVERCREEK, OH 45431-2565
(937) 429-7307
(937) 429-7320
Mailing address
3359 KEMP RD, STE. 200, BEAVERCREEK, OH 45431-2565
(937) 429-7307
(937) 429-7320
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
35064602
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000011941
ANTHEM
OH
05
—
0918243
—
OH
01
—
240004305
RAILROAD MEDICARE
OH
Enumeration date
07/14/2005
Last updated
04/06/2022
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