Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35128201 | OH |
Y | 208600000X | Surgeon | 35128201 | OH |
NPI | 1003106089 |
---|---|
Provider Name | Dr. Anthony Michael Calabretta |
First Address | Wooster, OH 44691-2342 |
Second Address | Wooster, OH 44691-6109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2011 |
Last Update Date | 25/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H312730 | (02) | OH |