MEDICARE: UVPC 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

General Provider Information

NPI Number	:	1639261944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UVPC SPECIALISTS INC.

Provider Business Mailing Address
First Line	:	PO BOX 479
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-0479
Country	:	US
Telephone Number	:	937-335-6463
Fax Number	:	937-440-7230

Provider Business Practice Location Address
First Line	:	31 S STANFIELD RD
Second Line	:	SUITE 206
City	:	TROY
State	:	OH
Zip	:	45373-2374
Country	:	US
Telephone Number	:	937-335-6463
Fax Number	:	937-440-7230

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CONNIE K. HOLDEN
Credential	:
Telephone Number	:	937-440-7497

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	06/18/2008

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Directions to “UVPC SPECIALISTS INC. ” Practice Location

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