Provider Demographics
NPI:1932334083
Name:INTERNAL MEDICINE ASSOCIATES, INC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES, INC
Other - Org Name:RN FIRST ASSISTANT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNTS REPRESENTATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-384-6845
Mailing Address - Street 1:2115 LEITER RD
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3659
Mailing Address - Country:US
Mailing Address - Phone:937-384-6833
Mailing Address - Fax:937-384-6939
Practice Address - Street 1:3535 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1221
Practice Address - Country:US
Practice Address - Phone:937-395-8842
Practice Address - Fax:937-395-8379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHIN9927371Medicare PIN