Organization
MONT GREEN ANESTHESIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS D KAMINSKI MD (PRESIDENT)
(937) 297-6072
Entity
Organization
Contact information
Practice address
707 S. EDWIN C. MOSES BLVD., DAYTON, OH 45408-1462
(937) 221-8000
(937) 221-8529
Mailing address
3180 KETTERING BLVD, DAYTON, OH 45439-1924
(937) 297-6072
(937) 293-0969
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381907
ANTHEM
OH
05
—
2600537
—
OH
05
—
2600546
—
OH
05
—
2600555
—
OH
05
—
2600564
—
OH
05
—
2600573
—
OH
01
—
565255007005
MEDICAL MUTUAL OF OHIO
OH
01
—
DD8829
RAILROAD MEDICARE
OH
Enumeration date
02/01/2006
Last updated
04/20/2008
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