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NPI Code Detail

MEDICARE: KETTERING PEDIATRIC & FAMILY CARE, INC.

MEDICARE: KETTERING PEDIATRIC & FAMILY CARE, 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
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1730837394
Entity Type Code : Organization
Provider Name (Legal Business Name) : KETTERING PEDIATRIC & FAMILY CARE, INC.
Provider Business Mailing Address
First Line : 5250 FAR HILLS AVE STE 260
Second Line :
City : DAYTON
State : OH
Zip : 45429-2357
Country : US
Telephone Number : 937-293-4168
Fax Number : 937-293-2235
Provider Business Practice Location Address
First Line : 5250 FAR HILLS AVE STE 260
Second Line :
City : DAYTON
State : OH
Zip : 45429-2357
Country : US
Telephone Number : 937-293-4168
Fax Number : 937-293-2235
Authorized Official
Title or Position : PRESIDENT
Name : DR. RAMZIEH AZMEH
Credential : MD
Telephone Number : 937-293-4168
Provider Enumeration Date : 03/14/2022
Last Update Date : 03/14/2022

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Directions to “KETTERING PEDIATRIC & FAMILY CARE, INC. ” Practice Location

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