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General NPI Number Information
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NPI Number | 1073815122
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Entity Type | Organization
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Legal Business Name | PIONEER HEALTH ASSOCIATES, LLC
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 9223 GREAT LAKES CIR
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City | CENTERVILLE
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State | OH
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Zip | 45458-3677
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Country | US
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Telephone | 937-912-9428
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Fax |
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Provider Business Mailing Address
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Address Line | 9223 GREAT LAKES CIR
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City | CENTERVILLE
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State | OH
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Zip | 45458-3677
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Country | US
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Telephone | 937-912-9428
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMEER AHMED
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Credential | M.D.
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Telephone | 937-912-9428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35-091940
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License Number State | OH
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