Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35-07-8008-B | OH |
N | 207XS0106X | Orthopaedic Hand Surgeon | 35-07-8008-B | OH |
NPI | 1003923335 |
---|---|
Provider Name | John S. Bucchieri |
First Address | Mentor, OH 44060-8713 |
Second Address | Mentor, OH 44060-8713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2185648 | (05) | OH |
H15514 | (02) | OH |