Organization
DAYTON ARTHRITIS AND ALLERGY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W. STEVENS M.D. (PHYSICIAN)
(937) 296-0015
Entity
Organization
Contact information
Practice address
3075 GOVERNORS PLACE BLVD, SUITE 110, DAYTON, OH 45409-1323
(937) 296-0015
Mailing address
3075 GOVERNORS PLACE BLVD, SUITE 110, DAYTON, OH 45409-1332
(937) 296-0015
Taxonomy
Speciality
Code
Description
License number
State
207RI0001X
Clinical & Laboratory Immunology (Internal Medicine) Physician
—
—
207RR0500X
Rheumatology Physician
Primary
—
—
2080P0201X
Pediatric Allergy/Immunology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2347866
—
OH
01
—
CJ9805
RAILROAD MEDICARE
OH
Enumeration date
10/17/2006
Last updated
09/24/2008
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