Individual
ALYSSA JENNIFER GANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3535 PENTAGON BLVD STE 330, BEAVERCREEK, OH 45431-1705
(937) 395-8556
(937) 395-6376
Mailing address
3535 PENTAGON BLVD STE 330, BEAVERCREEK, OH 45431-1705
(937) 395-8556
(937) 395-6376
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35.097120
OH
2086S0102X
Surgical Critical Care Physician
35.097120
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111981
—
OH
Enumeration date
06/03/2009
Last updated
03/17/2018
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