Physician Compare National (NPI:1104808518)

HEALTHCARE PROVIDER: DENNIS MIN D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1104808518
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789670860
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040423000275
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MIN
	Individual professional last name
Provider First Name	DENNIS
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1537 S BREIEL BLVD
	Group Practice or individual's line 1 address
City	MIDDLETOWN
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	450446703
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360133
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GRANDVIEW AND SOUTHVIEW HOSPITALS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360079
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	KETTERING MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360132
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	FORT HAMILTON HUGHES MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y