Healthcare Provider Details

I. General information

NPI: 1952445637
Provider Name (Legal Business Name): STEPHEN DONA, D. O.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8934 KINGSRIDGE DR STE 102
CENTERVILLE OH
45458-1626
US

IV. Provider business mailing address

8934 KINGSRIDGE DR STE 102
CENTERVILLE OH
45458-1633
US

V. Phone/Fax

Practice location:
  • Phone: 937-439-6242
  • Fax: 937-439-6245
Mailing address:
  • Phone: 937-439-6242
  • Fax: 937-439-6245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN L DONA
Title or Position: OWNER
Credential: D.O.
Phone: 937-439-6242