Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35-121749 | OH |
NPI | 1043281181 |
---|---|
Provider Name | Antonio Sortino |
First Address | Dublin, OH 43017-0727 |
Second Address | Mansfield, OH 44903-2269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 25/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001049561 | (05) | PA |
171015901 | INTERGROUP (01) | PA |
529988 | HIGHMARK/KEYSTONE (01) | PA |