Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 35.126257 | OH |
NPI | 1689930737 |
---|---|
Provider Name | Mark E Minor |
First Address | Dayton, OH 45404-1815 |
Second Address | Dayton, OH 45404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2012 |
Last Update Date | 19/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0241775 | (05) | OH |