| Dr Daniel Thomas Pucheril, MD, MBA | |
|
3737 Southern Blvd Ste 4200, Kettering, OH 45429-0135 | |
| (937) 294-1489 | |
| (937) 294-7999 |
| Full Name | Dr Daniel Thomas Pucheril |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 14 Years |
| Location | 3737 Southern Blvd Ste 4200, Kettering, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215298104 | NPI | - | NPPES |
| 0359824 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 4301100400 (Michigan) | Secondary |
| 208800000X | Urology | 35.134964 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kettering Medical Center | Kettering, OH | Hospital |
| Grandview And Southview Hospitals | Dayton, OH | Hospital |
| Soin Medical Center | Beaver creek, OH | Hospital |
| Kettering Medical Center - Sycamore | Miamisburg, OH | Hospital |
| Greene Memorial Hospital | Xenia, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kettering Independent Medical Group Inc | 3173710936 | 602 |
| Entity Name | Kettering Independent Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629387865 PECOS PAC ID: 3173710936 Enrollment ID: O20101207000425 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Daniel Thomas Pucheril, MD, MBA 3737 Southern Blvd Ste 4200, Kettering, OH 45429-0135 Ph: (937) 294-1489 | Dr Daniel Thomas Pucheril, MD, MBA 3737 Southern Blvd Ste 4200, Kettering, OH 45429-0135 Ph: (937) 294-1489 |
Rajiva Ranjan Singh, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3737 Southern Blvd., Suite 4200, Kettering, OH 45429 Phone: 937-294-1489 Fax: 937-297-6468 | |
David A Hadley, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 3737 Southern Blvd Ste 4200, Kettering, OH 45429 Phone: 937-294-1489 Fax: 937-297-6468 | |
Dr. Sammy A. Hamway, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 10 Southmoor Cir Nw, Kettering, OH 45429 Phone: 937-294-1489 Fax: 937-297-6468 | |
Kuwong Bomwara Mwamukonda, M. D. Urology Medicare: Accepting Medicare Assignments Practice Location: 3737 Southern Blvd Ste 4200, Kettering, OH 45429 Phone: 937-294-1489 Fax: 937-294-7999 |