Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | OS004082L | PA |
Y | 207R00000X | Internist | 2622 | OH |
Y | 111NI0900X | Internist | 2622 | OH |
N | 207R00000X | Internist | OS004082-L | PA |
N | 111NI0900X | Internist | OS004082-L | PA |
NPI | 1003876202 |
---|---|
Provider Name | Dr. Roy John Sartori |
First Address | Warren, OH 44484-4503 |
Second Address | Warren, OH 44484-4503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 12/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007119980005 | (05) | PA |
0433374 | (05) | OH |
100748346 | (05) | PA |
B40276 | (02) | PA |