Healthcare Provider Details

I. General information

NPI: 1194717454
Provider Name (Legal Business Name): JOHN CHARLES ANDREOZZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 NAVE RD SE FL 1
MASSILLON OH
44646-9604
US

IV. Provider business mailing address

3325 SUMSER ST NW
NORTH CANTON OH
44720-7954
US

V. Phone/Fax

Practice location:
  • Phone: 330-830-3393
  • Fax: 234-521-7091
Mailing address:
  • Phone: 330-499-7219
  • Fax: 330-588-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number35.038342
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: