Healthcare Provider Details

I. General information

NPI: 1477827947
Provider Name (Legal Business Name): PREMIER HEALTH SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2012
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 N MAIN ST STE 101
DAYTON OH
45415-1180
US

IV. Provider business mailing address

9000 N MAIN ST STE 101
DAYTON OH
45415-1180
US

V. Phone/Fax

Practice location:
  • Phone: 937-832-2425
  • Fax: 937-832-9804
Mailing address:
  • Phone: 937-832-2425
  • Fax: 937-832-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DANIS
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 937-499-8866