Basic Information
| Provider Information | |||||||||
| NPI: | 1235357112 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PULMONARY MEDICINE OF DAYTON, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 933242 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441930035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374393600 | ||||||||
| FaxNumber: | 9374393786 | ||||||||
| Practice Location | |||||||||
| Address1: | 6728 LOOP ROAD SUITE 304 | ||||||||
| Address2: | |||||||||
| City: | CENTERVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374393600 | ||||||||
| FaxNumber: | 9374393786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 06/28/2018 | ||||||||
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| AuthorizedOfficialLastName: | CROSS | ||||||||
| AuthorizedOfficialFirstName: | HOLLY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9374393600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.