Basic Information
| Provider Information | |||||||||
| NPI: | 1154323384 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASSENMACHER | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2751 BAY PARK DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | OREGON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436164921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196908811 | ||||||||
| FaxNumber: | 4196975760 | ||||||||
| Practice Location | |||||||||
| Address1: | 2751 BAY PARK DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | OREGON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436164921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196908811 | ||||||||
| FaxNumber: | 4196975760 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 02/17/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 35039245 | OH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 000000510600 | 01 | OH | ANTHEM | OTHER | 0305299 | 05 | OH | MEDICAID | 48-0300 | 01 | OH | UHC | OTHER | P00370476 | 01 | OH | RRMC | OTHER | 00204 | 01 | OH | PARAMOUNT | OTHER | 4074089 | 01 | OH | AETNA | OTHER |