IndividualActive
Douglas Tidwell, CCP
NPI 1265672505 · Perfusionist · Kettering, OH
Provider details
- NPI number
- 1265672505
- Entity type
- Individual
- Primary specialty
- PerfusionistTechnologists, Technicians & Other Technical Service Providers
- Credential
- CCP
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
580 Lincoln Park Blvd
Suite 322
Kettering, OH 45429-3474
Phone: (937) 297-6800
Fax: (937) 297-6810
Approximate (ZIP-level) locationGet directions
Mailing address
580 Lincoln Park Blvd
Kettering, OH 45429-3474
Registry dates
- Enumerated
- 2009-02-26
- Last updated
- 2009-02-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.