Healthcare Provider Details

I. General information

NPI: 1962783324
Provider Name (Legal Business Name): PREMIER HEALTH SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST BERRY BLDG, GROUND FL
DAYTON OH
45409-2722
US

IV. Provider business mailing address

1 WYOMING ST BERRY BLDG, GROUND FL
DAYTON OH
45409-2722
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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