Provider Demographics
NPI:1508040908
Name:ASTHMA AND RESPIRATORY CENTER OF SOUTH DAYTON INC
Entity Type:Organization
Organization Name:ASTHMA AND RESPIRATORY CENTER OF SOUTH DAYTON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:WAGSHUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-859-5864
Mailing Address - Street 1:PO BOX 636746
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:937-859-5864
Mailing Address - Fax:937-859-8858
Practice Address - Street 1:8371 YANKEE ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-1810
Practice Address - Country:US
Practice Address - Phone:937-859-5864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2310369Medicaid
OH9262441Medicare PIN