Healthcare Provider Details

I. General information

NPI: 1285021782
Provider Name (Legal Business Name): DAYTON SPRINGFIELD CARDIOVASCULAR & FAMILY MEDICINE LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 E HOME RD
SPRINGFIELD OH
45503-2725
US

IV. Provider business mailing address

1117 E HOME RD
SPRINGFIELD OH
45503-2725
US

V. Phone/Fax

Practice location:
  • Phone: 937-505-9501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MOHAMMAD ANWARUL KABIR
Title or Position: CO-PARTNER
Credential: MD
Phone: 937-271-9408