Provider Demographics
NPI:1437151214
Name:KILIAN, STEVEN DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:KILIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 S MAIN ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2698
Mailing Address - Country:US
Mailing Address - Phone:937-224-8890
Mailing Address - Fax:937-224-0140
Practice Address - Street 1:160 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2740
Practice Address - Country:US
Practice Address - Phone:937-224-8890
Practice Address - Fax:937-224-0140
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35041302K174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000013989OtherANTHEM
OHKI0478665Medicare PIN
OH000000013989OtherANTHEM