Main Street Family Practice Inc

LBN: Main Street Family Practice Inc
Main Street Family Practice Inc is an health care organization with primary practice located at 9000 North Main Street Suite 403, Dayton OH 45415-1180. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Main Street Family Practice Inc can be contacted via phone (937) 836-5171, or through Fujimura, Martin K via phone (937) 836-5171.

Contact Information

Primary practice address
9000 North Main Street Suite 403 Dayton OH 45415-1180
Phone: (937) 836-5171
Fax: (937) 832-0728
Website:
Map and Directions
Authorized official contact:
Name: Fujimura, Martin K Doctor of Medicine (MD)
Phone: (937) 836-5171

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Ohio

Profile Details

NPI number 1093864035
LBN Legal business name Main Street Family Practice Inc
DBA Doing business as
Authorized official Fujimura, Martin K Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 9th, 2007
Last updated Jul 21st, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093864035 NPPES
Other 00000013156 ANTHEM BCBS
MEDICAID 0668433 ANTHEM BCBS

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