Provider Demographics
NPI:1508028317
Name:MIAMI VALLEY HOSPITALIST GROUP
Entity Type:Organization
Organization Name:MIAMI VALLEY HOSPITALIST GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:FNPC
Authorized Official - Phone:937-208-8393
Mailing Address - Street 1:220 DOLORES CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1203
Mailing Address - Country:US
Mailing Address - Phone:937-832-8193
Mailing Address - Fax:
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-3667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIAMI VALLEY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN219918COA1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital