Healthcare Provider Details

I. General information

NPI: 1053386102
Provider Name (Legal Business Name): DAYTON OSTEOPATHIC HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1989 MIAMISBURG CENTERVILLE RD SUITE 204
DAYTON OH
45459-3859
US

IV. Provider business mailing address

1 PRESTIGE PL
MIAMISBURG OH
45342-3794
US

V. Phone/Fax

Practice location:
  • Phone: 937-401-6822
  • Fax: 937-401-6910
Mailing address:
  • Phone: 937-762-1310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL DAVID MEWHIRTER
Title or Position: CFO
Credential:
Phone: 937-395-8994