Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 36001780 | OH |
NPI | 1245234806 |
---|---|
Provider Name | Dr. Jerauld D Ferritto JR. |
First Address | Grove City, OH 43123-2235 |
Second Address | Grove City, OH 43123-2235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 06/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0331466 | (05) | OH |
T97069 | (02) | OH |