MEDICARE: DIGESTIVE SPECIALISTS INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1467697441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGESTIVE SPECIALISTS INC

Provider Business Mailing Address
First Line	:	999 BRUBAKER DR
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-3588
Country	:	US
Telephone Number	:	937-293-4424
Fax Number	:	937-395-3682

Provider Business Practice Location Address
First Line	:	7790 DAYTON SPRINGFIELD RD STE B
Second Line	:
City	:	FAIRBORN
State	:	OH
Zip	:	45324-1996
Country	:	US
Telephone Number	:	937-293-4424
Fax Number	:	937-395-3682

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAMESH K GANDHI
Credential	:	MD
Telephone Number	:	937-313-0082

Provider Enumeration Date	:	12/05/2008
Last Update Date	:	12/05/2008

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