MEDICARE: DIGESTIVE SPECIALISTS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306818000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGESTIVE SPECIALISTS INC

Provider Business Mailing Address
First Line	:	999 BRUBAKER DR
Second Line	:	#1
City	:	KETTERING
State	:	OH
Zip	:	45429
Country	:	US
Telephone Number	:	937-293-2169
Fax Number	:	937-297-2203

Provider Business Practice Location Address
First Line	:	1244 MEADOW BRIDGE DR
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45434
Country	:	US
Telephone Number	:	937-293-2169
Fax Number	:	937-297-2203

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAMESH K GANDHI
Credential	:	MD
Telephone Number	:	937-293-2169

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	08/22/2020

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Directions to “DIGESTIVE SPECIALISTS INC ” Practice Location

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