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General NPI Number Information
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NPI Number | 1811944531
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Entity Type | Organization
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Legal Business Name | PREMIER CARDIOTHORACIC AND VASCULAR SURGEONS INC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 30 E APPLE ST STE 6200
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City | DAYTON
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State | OH
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Zip | 45409-2939
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Country | US
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Telephone | 937-275-5100
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Fax | 937-275-4587
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Provider Business Mailing Address
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Address Line | PO BOX 73392
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City | CLEVELAND
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State | OH
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Zip | 44193-0002
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Country | US
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Telephone | 937-293-0247
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Fax | 937-293-0960
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Authorized Official
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Title or Position | PRESIDENT
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Name | KOK H LIM
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Credential | MD
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Telephone | 937-275-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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