Healthcare Provider Details

I. General information

NPI: 1891932604
Provider Name (Legal Business Name): PREMIER HEALTH SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5450 FAR HILLS AVE SUITE 124
KETTERING OH
45429-2386
US

IV. Provider business mailing address

5450 FAR HILLS AVE SUITE 124
KETTERING OH
45429-2386
US

V. Phone/Fax

Practice location:
  • Phone: 937-435-2920
  • Fax:
Mailing address:
  • Phone: 937-435-2920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DANIS
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 937-435-4263