Healthcare Provider Details

I. General information

NPI: 1184617300
Provider Name (Legal Business Name): CHARLES PATRICK SAMMARONE JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 N MAIN ST
HUBBARD OH
44425-1126
US

IV. Provider business mailing address

730 N MAIN ST
HUBBARD OH
44425-1126
US

V. Phone/Fax

Practice location:
  • Phone: 330-534-1959
  • Fax: 330-534-2206
Mailing address:
  • Phone: 330-534-1959
  • Fax: 330-534-2206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.006563
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: