Healthcare Provider Details

I. General information

NPI: 1598997306
Provider Name (Legal Business Name): SETH H VOGELSTEIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 FAR HILLS AVE SUITE 309
DAYTON OH
45419-1687
US

IV. Provider business mailing address

2600 FAR HILLS AVE SUITE 309
DAYTON OH
45419-1687
US

V. Phone/Fax

Practice location:
  • Phone: 937-296-4000
  • Fax: 937-296-4004
Mailing address:
  • Phone: 937-296-4000
  • Fax: 937-296-4004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number34.004703
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34.004703
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number34.004703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: