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General NPI Number Information
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NPI Number | 1760753180
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTH SPECIALIST, INC
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 1 WYOMING ST BERRY BLDG, GROUND FL, STE B
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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 | 937-208-2901
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Fax | 937-208-2014
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Provider Business Mailing Address
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Address Line | 1 WYOMING ST BERRY BLDG, GROUND FLOOR, STE B
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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 | 937-208-8301
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Fax | 937-208-2014
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | CHRISTOPHER DANIS
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Credential | MD
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Telephone | 937-499-8866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State |
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