MEDICARE: UPPER VALLEY PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	208M00000X	Hospitalist Physician
3	363L00000X	Nurse Practitioner
4	363A00000X	Physician Assistant
5	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407872518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPPER VALLEY PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 479
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-0479
Country	:	US
Telephone Number	:	937-440-7497
Fax Number	:	937-440-7337

Provider Business Practice Location Address
First Line	:	3130 N COUNTY ROAD 25A
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-1337
Country	:	US
Telephone Number	:	937-440-7497
Fax Number	:	937-440-7337

Authorized Official
Title or Position	:	SYSTEMS SUPPORT ANALYST
Name	:	DARLENE F MICHEL
Credential	:
Telephone Number	:	937-499-6758

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	01/15/2026

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Directions to “UPPER VALLEY PROFESSIONAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

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