Healthcare Provider Details

I. General information

NPI: 1235117706
Provider Name (Legal Business Name): MIDWEST HYPERBARIC PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 SOUTHERN BLVD
KETTERING OH
45429-1221
US

IV. Provider business mailing address

8280 YANKEE ST
CENTERVILLE OH
45458-1806
US

V. Phone/Fax

Practice location:
  • Phone: 937-384-8772
  • Fax: 937-384-4853
Mailing address:
  • Phone: 937-436-4658
  • Fax: 937-436-4984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LOUIS E PILATI
Title or Position: PRESIDENT
Credential: MD
Phone: 937-436-4658