Healthcare Provider Details

I. General information

NPI: 1164594834
Provider Name (Legal Business Name): OHIO INSTITUTE FOR COMPREHENSIVE PAIN MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 E ALEX BELL RD
DAYTON OH
45459-2658
US

IV. Provider business mailing address

1235 E ALEX BELL RD
DAYTON OH
45459-2658
US

V. Phone/Fax

Practice location:
  • Phone: 937-435-6400
  • Fax: 937-435-4793
Mailing address:
  • Phone: 937-435-6400
  • Fax: 937-435-4793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MERVET K SALEH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 937-435-6400