Healthcare Provider Details

I. General information

NPI: 1609967793
Provider Name (Legal Business Name): STEVEN E LATULIPPE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W 5TH ST
EAST LIVERPOOL OH
43920-2405
US

IV. Provider business mailing address

PO BOX 5254
POLAND OH
44514-0254
US

V. Phone/Fax

Practice location:
  • Phone: 330-385-7200
  • Fax: 330-776-5557
Mailing address:
  • Phone: 330-520-2221
  • Fax: 330-776-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number35077781
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207ZI0100X
TaxonomyImmunopathology Physician
License Number35077781
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number35077781
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number35077781
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: