Provider Demographics
NPI:1649203407
Name:MONCRIEF, HUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:
Last Name:MONCRIEF
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 1:30 E APPLE ST
Mailing Address - Street 2:SUITE 6254
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2939
Mailing Address - Country:US
Mailing Address - Phone:937-208-4812
Mailing Address - Fax:937-208-2898
Practice Address - Street 1:30 E APPLE ST
Practice Address - Street 2:SUITE 6254
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2939
Practice Address - Country:US
Practice Address - Phone:937-208-4812
Practice Address - Fax:937-208-2898
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056007M207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0689643Medicaid
OH0604025Medicare ID - Type Unspecified
OHA17079Medicare UPIN
OH0604023Medicare ID - Type Unspecified
OH0689643Medicaid