Providence Medical Group
Providence Medical Group is a Registered Dietitian in Dayton, Ohio. Licensed in Ohio. Registered with an NPI since 2006.
- Licensed in
- OH
- In the registry since
- 2006
- Specialties on file
- 15
Practice location Address checks out
2912 Springboro Rd W Ste 201Dayton, OH 45439-1674
Phone: (937) 297-8999
Fax: (937) 297-4852
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X |
|---|---|
| Registered Dietitian | Taxonomy 133V00000X (OH) |
| Diabetes Educator Registered Nurse | Taxonomy 163WD0400X (OH) |
| Obstetrics & Gynecology Physician | Taxonomy 207V00000X |
| Pediatrics Physician | Taxonomy 208000000X |
| Surgery Physician | Taxonomy 208600000X |
| Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician | Taxonomy 2088F0040X |
| Colon & Rectal Surgery Physician | Taxonomy 208C00000X |
| General Practice Physician | Taxonomy 208D00000X |
| Clinical Medical Laboratory | Taxonomy 291U00000X |
| Medical Physician Assistant | Taxonomy 363AM0700X |
| Nurse Practitioner | Taxonomy 363L00000X · Licence 1313008 (OH) |
| Acute Care Nurse Practitioner | Taxonomy 363LA2100X |
| Adult Health Nurse Practitioner | Taxonomy 363LA2200X |
| Pediatric Nurse Practitioner | Taxonomy 363LP0200X |
Record details
| NPI number | 1972533149 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Susan Becker — Chief Operating Officer · (937) 297-8999 |
| NPI enumerated | July 4, 2006 |
| Last updated in NPPES | October 19, 2022 |
| Certification date | October 19, 2022 |
| Mailing address | 2912 Springboro Rd W, Suite 201, Dayton, OH 45439-1674 |
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