Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 35043841 | OH |
Y | 2084N0400X | Neurologist | 35043841 | OH |
NPI | 1073511531 |
---|---|
Provider Name | Donald Joseph Tamulonis JR. |
First Address | Youngstown, OH 44504-1125 |
Second Address | Youngstown, OH 44504-1125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 06/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0557026 | (05) | OH |
C02562 | (02) | OH |
H141360 | MEDICARE PTAN (01) | OH |