Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 36-00-1903 | OH |
Y | 222Z00000X | Podiatrist | 36-00-1903 | OH |
NPI | 1043218506 |
---|---|
Provider Name | Dr. Jeffrey Michael Ferritto |
First Address | Columbus, OH 43207-4011 |
Second Address | Columbus, OH 43207-4011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 14/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000115763 | ANTHEM BC/BS (01) | |
0457241 | (05) | OH |
T80508 | (02) | OH |