Unknown Individual – Physician Assistant, NPI 1104866409
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
4750, Hempstead Station Drive, Kettering, Montgomery County, Ohio, 45429, United States
KETTERING, OH 454295164
Phone: (800) 875-0136
Fax: (937) 619-4231
Type: Mailing
Avita Galion Hospital, 269, Portland Way South, Galion, Crawford County, Ohio, 44833, United States
GALION, OH 448332312
Phone: (419) 468-4841
Fax: (419) 462-0500
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45429)
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