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General NPI Number Information
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NPI Number | 1437469541
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Entity Type | Organization
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Legal Business Name | MIAMI VALLEY EMERGENCY SPECIALISTS LLC
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 1 WYOMING ST
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City | DAYTON
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State | OH
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Zip | 45409-2722
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Country | US
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Telephone | 937-208-5626
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WYOMING ST
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City | DAYTON
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State | OH
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Zip | 45409-2722
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HEAD PHYSICIAN
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Name | DR. DARIN PANGALANGAN
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Credential |
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Telephone | 937-208-5626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50000763
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License Number State | OH
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