Provider Demographics
NPI:1982670097
Name:BRIGGS, VILMA K (MD)
Entity Type:Individual
Prefix:
First Name:VILMA
Middle Name:K
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VILMA
Other - Middle Name:R
Other - Last Name:KISTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3170 KETTERING BLVD BLDG B3
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3188
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:WYOMING ST BERRY WOMEN'S CENTER LABOR & DELIVERY
Practice Address - Street 2:STE 4130
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-439-4381
Practice Address - Fax:937-641-2524
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-068327207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000332807OtherANTHEM
OH0177946Medicaid
OH0177946Medicaid
OH7318441Medicare ID - Type Unspecified