Providence Medical Group

Specialty details in registry · Moraine, OH

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At a glance

2912 Springboro W, Moraine, OH 45439-1674

NPPES record updated Nov 26, 2014. Public records can lag behind changes at a practice.

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Are you accepting new patients?
Do you accept my specific insurance plan?
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Insurance participation and appointment availability are not established by these public records.

Practice location

2912 Springboro W Suite 203
Moraine, OH 45439-1674

Professional details: NPI, taxonomy & registry record

NPI1760658371

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 291U00000X
Enumeration date: May 3, 2008
Record updated: Nov 26, 2014

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

291U00000X · Primary

License reported: 016189 OH

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

2912 Springboro W
Suite 203
Moraine, OH 45439-1674

Phone: (937) 297-8999
Fax: (937) 298-9673

Mailing address

2912 SPRINGBORO W
SUITE 203
MORAINE, OH 454391674

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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