MAIN STREET FAMILY PRACTICE INC NPI 1093864035

NPI Information

  • NPI: 1093864035
  • Provider Name: MAIN STREET FAMILY PRACTICE INC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 36D0349520
  • Address: 9000 NORTH MAIN STREET
    SUITE 403
    DAYTON, OH
    ZIP 45415
  • Phone: (937) 836-5171

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NPI Details

MAIN STREET FAMILY PRACTICE INC is a family medicine in Dayton, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MAIN STREET FAMILY PRACTICE INC NPI is 1093864035. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9000 NORTH MAIN STREET
SUITE 403
DAYTON, OH
ZIP 45415-180
Phone: (937) 836-5171
Fax: (937) 832-0728

The provider's authorized official is Martin K Fujimura .
The authorized official title is President and has the following contact phone number (937) 836-5171.

The CLIA number assigned to this NPI record is 36D0349520 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/9/2007 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineOHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10668433MEDICAIDOHIO
200000013156OTHERANTHEM BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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