De Vries, Jennifer Maria

De Vries, Jennifer Maria is an individual health care provider with primary practice located at 1 Childrens Plz , Dayton OH 45404-1815. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Anesthesiology, which is considered as her primary health care specialty. De Vries, Jennifer Maria can be contacted via phone (937) 641-3477.

Contact Information

Primary practice address
1 Childrens Plz Dayton OH 45404-1815
Fax: (937) 641-5410
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Anesthesiology 207LP3000X 35.064110 Ohio

Profile Details

NPI number 1891768974
LBN Legal business name De Vries, Jennifer Maria
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Oct 10th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891768974 NPPES
Ohio MEDICAID 0144007

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