Organization
MARYSVILLE PEDIATRICS INC
Active
Organization
MARYSVILLE PEDIATRICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKOLA T ALAIN MD (MEDICAL DIRECTOR)
(937) 644-1920
Entity
Organization
Contact information
Practice address
610 S PLUM ST, MARYSVILLE, OH 43040-1630
(937) 644-1920
(937) 644-2024
Mailing address
610 S PLUM ST, MARYSVILLE, OH 43040-1630
(937) 644-1920
(937) 644-2024
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
34-007191
OH
208000000X
Pediatrics Physician
35-050943
OH
208000000X
Pediatrics Physician
Primary
35-083181
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2244016
—
OH
Enumeration date
07/22/2005
Last updated
08/22/2020
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