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General NPI Number Information
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NPI Number | 1447451661
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ALLERGY GENERAL PHYSICIANS OF OHIO INC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 10/05/2009
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Provider Practice Location Address
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Address Line | 5212 BRANDT PIKE SUITE A
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-6138
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Country | US
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Telephone | 937-233-0748
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Fax | 937-233-6086
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Provider Business Mailing Address
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Address Line | 5212 BRANDT PIKE SUITE A
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-6138
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Country | US
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Telephone | 937-233-0748
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Fax | 937-233-6086
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Authorized Official
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Title or Position | CORPORATION SECRETARY
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Name | MRS. THERESA LYNN MCFARLAND
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Credential |
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Telephone | 937-233-0748
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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 | 35058434M
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 34003765
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 35043565M
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License Number State | OH
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