Healthcare Provider Details

I. General information

NPI: 1811961006
Provider Name (Legal Business Name): WILLIAM D. FIORINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14210 SCOTTSLAWN RD.
MARYSVILLE OH
43041-0001
US

IV. Provider business mailing address

14210 SCOTTSLAWN RD.
MARYSVILLE OH
43041-0001
US

V. Phone/Fax

Practice location:
  • Phone: 937-578-5555
  • Fax: 937-578-5870
Mailing address:
  • Phone: 614-292-0110
  • Fax: 614-247-6074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number35-047010
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-047010
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: