Healthcare Provider Details

I. General information

NPI: 1881652287
Provider Name (Legal Business Name): JOHN RICHARD DYLEWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/06/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 JOHNSON RD STE 202
STEUBENVILLE OH
43952-2372
US

IV. Provider business mailing address

MSO PHYSICIAN BILLING 380 SUMMIT AVENUE
STEUBENVILLE OH
43952-2667
US

V. Phone/Fax

Practice location:
  • Phone: 740-314-8433
  • Fax: 740-672-3363
Mailing address:
  • Phone: 740-283-7597
  • Fax: 740-283-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.148307
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35.148307
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: