Provider Demographics
NPI:1548213036
Name:MVHE INC
Entity Type:Organization
Organization Name:MVHE INC
Other - Org Name:CHRISTINA G WAITE MD & ASSOCIATES COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-208-8213
Mailing Address - Street 1:722 N FAIRFIELD RD
Mailing Address - Street 2:STE 200
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-5918
Mailing Address - Country:US
Mailing Address - Phone:937-208-7022
Mailing Address - Fax:937-208-7010
Practice Address - Street 1:722 N FAIRFIELD RD
Practice Address - Street 2:STE 200
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-5918
Practice Address - Country:US
Practice Address - Phone:937-208-7022
Practice Address - Fax:937-208-7010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MVHE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-18
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2576869Medicaid
OH2576869Medicaid