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General NPI Number Information
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NPI Number | 1679776157
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Entity Type | Individual
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Provider Name | DON J MASCARENHAS MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 3700 SOUTHERN BLVD STE 300
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City | KETTERING
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State | OH
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Zip | 45429-1265
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Country | US
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Telephone | 937-643-9299
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Fax | 937-643-2343
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Provider Business Mailing Address
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Address Line | 3700 SOUTHERN BLVD STE 300
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City | KETTERING
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State | OH
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Zip | 45429-1226
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Country | US
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Telephone | 937-643-9299
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Fax | 937-643-2343
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME99009
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35.126656
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License Number State | OH
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