Healthcare Provider Details

I. General information

NPI: 1730184698
Provider Name (Legal Business Name): PERINATAL PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE WYOMING ST BERRY BLDG
DAYTON OH
45409-2793
US

IV. Provider business mailing address

ONE WYOMING ST BERRY BLDG
DAYTON OH
45409-2793
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-2516
  • Fax: 937-208-6124
Mailing address:
  • Phone: 937-208-6088
  • Fax: 937-208-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number200020700190
License Number StateOH

VIII. Authorized Official

Name: TERRY L. STUERMAN
Title or Position: VP TREAS.
Credential:
Phone: 937-208-6088