Individual
PAVANI DANTALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, MIDDLETOWN, OH 45005-2584
(513) 705-4754
(513) 420-5156
Mailing address
1 MEDICAL CENTER DR, MIDDLETOWN, OH 45005-2584
(513) 705-4754
(513) 420-5156
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.095144
OH
208M00000X
Hospitalist Physician
35095144
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3077674
—
OH
Enumeration date
06/06/2007
Last updated
12/10/2013
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