Provider Demographics
NPI:1437438330
Name:DIGESTIVE SPECIALISTS INC
Entity Type:Organization
Organization Name:DIGESTIVE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJKAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-396-2602
Mailing Address - Street 1:999 BRUBAKER DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3588
Mailing Address - Country:US
Mailing Address - Phone:937-534-7330
Mailing Address - Fax:937-297-2208
Practice Address - Street 1:1530 NEEDMORE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-3969
Practice Address - Country:US
Practice Address - Phone:937-534-7330
Practice Address - Fax:937-297-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0051193Medicaid
9272191Medicare PIN