Healthcare Provider Details

I. General information

NPI: 1497154983
Provider Name (Legal Business Name): DAVID ANGELO DELLIQUADRI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 E LIBERTY ST
GIRARD OH
44420-2648
US

IV. Provider business mailing address

100 DEBARTOLO PL STE 200
YOUNGSTOWN OH
44512-6095
US

V. Phone/Fax

Practice location:
  • Phone: 330-545-8643
  • Fax: 330-545-6557
Mailing address:
  • Phone: 330-729-8146
  • Fax: 330-965-5229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.012405
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: