Organization
MIAMI VALLEY COLON AND RECTAL SURGEONS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN A CONOVER (BUSINESS MANAGER)
(937) 293-6188
Entity
Organization
Contact information
Practice address
3080 ACKERMAN BLVD, SUITE 110, DAYTON, OH 45429-3561
(937) 293-6188
(937) 293-6196
Mailing address
3080 ACKERMAN BLVD, SUITE 110, DAYTON, OH 45429-3561
(937) 293-6188
(937) 293-6196
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
35065836
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330501
—
OH
Enumeration date
10/17/2007
Last updated
10/17/2007
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