Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 35054146 | OH |
NPI | 1124022645 |
---|---|
Provider Name | Beth Anne Berrettoni |
First Address | Dayton, OH 45459-4778 |
Second Address | Dayton, OH 45459-4778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 14/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000013732 | ANTHEM (01) | OH |
0878019 | (05) | OH |
09-20041 | UNITED HEALTHCARE (01) | OH |
D54146 | CHOICE CARE (01) | OH |
E89146 | (02) | OH |