Individual
PRADEESH M. GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3130 N COUNTY ROAD 25A STE 214, TROY, OH 45373-1337
(937) 332-8777
(937) 332-8773
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
34.010935
OH
2086S0102X
Surgical Critical Care Physician
34.010935
OH
2086S0127X
Trauma Surgery Physician
Primary
02004534A
IN
2086S0127X
Trauma Surgery Physician
34.010935
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0086021
—
OH
05
—
201290540
—
IN
Enumeration date
07/26/2008
Last updated
09/16/2020
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