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General NPI Number Information
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NPI Number | 1750523874
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Entity Type | Organization
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Legal Business Name | MEHAN OPHTHALMOLOGY, INC.
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 02/10/2010
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Provider Practice Location Address
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Address Line | 1020 WOODMAN DR SUITE 200
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City | DAYTON
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State | OH
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Zip | 45432-1446
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Country | US
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Telephone | 937-258-4570
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Fax | 937-258-4573
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Provider Business Mailing Address
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Address Line | 1020 WOODMAN DR SUITE 200
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City | DAYTON
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State | OH
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Zip | 45432-1446
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Country | US
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Telephone | 937-258-4570
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Fax | 937-258-4573
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANEESH KUMAR MEHAN
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Credential | M.D.
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Telephone | 937-258-4570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 093450O
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License Number State | OH
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