MEDICARE: DR. JOHN F OLIVETI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	350591020	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000115686	OTHER	OH	BLUE CROSS/BLUE SHIELD
3	729915	OTHER	OH	BUCKEYE COMMUNITY HEALTH

General Provider Information

NPI Number	:	1598763328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN F OLIVETI MD

Provider Business Mailing Address
First Line	:	1790 TOWN PARK BLVD
Second Line	:	STE I
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-7972
Country	:	US
Telephone Number	:	330-899-0300
Fax Number	:	330-899-9430

Provider Business Practice Location Address
First Line	:	1790 TOWN PARK BLVD
Second Line	:	STE I
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-7972
Country	:	US
Telephone Number	:	330-899-0300
Fax Number	:	330-899-9430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/13/2011

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