Provider Demographics
NPI:1134490931
Name:ALLIANCE PHYSICIANS INC
Entity Type:Organization
Organization Name:ALLIANCE PHYSICIANS INC
Other - Org Name:JOSEPH N GUNASEKERA, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-384-4838
Mailing Address - Street 1:2510 COMMONS BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3820
Mailing Address - Country:US
Mailing Address - Phone:937-558-3021
Mailing Address - Fax:937-558-3026
Practice Address - Street 1:2510 COMMONS BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3820
Practice Address - Country:US
Practice Address - Phone:937-558-3021
Practice Address - Fax:937-558-3026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLIANCE PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065843207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty