Provider Demographics
NPI:1659357770
Name:GARCIA, EMMA E (DO)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:E
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2912 SPRINGBORO W
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1674
Mailing Address - Country:US
Mailing Address - Phone:937-297-8996
Mailing Address - Fax:937-885-0702
Practice Address - Street 1:70 REMICK BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-9168
Practice Address - Country:US
Practice Address - Phone:937-885-0701
Practice Address - Fax:937-885-0702
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34004456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0714123Medicaid
OH34004456GOtherMEDICAL LICENSE
OH000000227886OtherUNICARE
OH17185OtherNATIONWIDE
OH4240229OtherAETNA
OHD0445603OtherHUMANA/CHOICECARE
OH421534506077OtherCARESOURCE
OH000000227886OtherANTHEM
OH28166974800OtherOHIO BWC
OH080191707OtherRAILROAD MEDICARE
OHF04199Medicare UPIN
OH0714123Medicaid