Individual
DR. JOSEPH ROBERT MASTANDREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4441 FAR HILLS AVE, KETTERING, OH 45429-2405
(937) 298-7351
(937) 298-9458
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34-003760
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0792763
—
OH
Enumeration date
08/22/2005
Last updated
04/06/2022
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